自身免疫性肝炎患者血清趋化因子CCL4和CXCL10水平及其临床意义探讨

doi:10.3969/j.issn.1672-5069.2021.06.015

摘要/Abstract

摘要： 目的探讨自身免疫性肝炎(AIH)患者血清趋化因子C-C-基元配体4(CCL4)和趋化因子配体10(CXCL10)水平及其临床意义。方法 2016年12月～2020年12月我院收治的72例AIH患者均接受2年以上指南推荐的标准化免疫抑制治疗方案。采用ELISA法检测血清CCL4和CXCL10水平,使用全自动生化分析仪检测血生化指标,常规行肝活检。结果在2年治疗末,本组患者不完全应答47例,完全应答25例;完全应答患者血清CCL4和CXCL10水平分别为(46.4±18.4)pg/ml和(42.2±8.5)pg/ml,显著低于不完全应答患者【分别为(61.3±22.6)pg/ml和(89.1±47.4)pg/ml, P<0.05】;在72例患者中,26例患者存在凝血功能指标异常,均为不完全应答患者;完全应答患者PT、APTT和TT水平分别为(11.8±1.3) s、(29.6±2.2) s和(15.6±1.2)s,显著低于不完全应答患者【分别为(13.9±3.6)s、(41.3±6.2)s和(18.9±1.9)s,P<0.05】,而FIB水平为(3.1±0.8)g/l,显著高于不完全应答患者【(3.7±1.2)g/l,P<0.05】;凝血功能正常患者血清CCL4和CXCL10水平分别为(50.2±16.5)pg/ml和(66.3±18.2)pg/ml,显著低于凝血功能异常患者【分别为(68.0±24.2)pg/ml和(85.5±39.7)pg/ml,P<0.05】。结论 AIH患者血清趋化因子CCL4和CXCL10水平可能影响治疗应答反应,且与凝血功能密切相关。检测血清CCL4和CXCL10水平可能有助于预测治疗应答。

关键词: 自身免疫性肝炎, 趋化因子C-C-基元配体4, 趋化因子配体10, 凝血功能, 治疗应答

Abstract: Objective The aim of this study was to investigate the changes of serum chemokine C-C-motif ligand 4 (CCL4) and C-X-C motif chemokine ligand 10 (CXCL10) levels in patients with autoimmune hepatitis (AIH). Methods A total of 72 patients with AIH were enrolled in our hospital between December 2016 and December 2020, and all patients received liver biopsy and standardized treatment recommended by related the guidelines for more than 2 years. Serum chemokines CCL4 and CXCL10 were detected by ELISA. Results At the end of two year treatment, 25 patients got complete response (CR) and 47 patients got incomplete response (IR); serum CCL4 and CXCL10 levels ad admission in patients with CR were (46.4±18.4)pg/ml and (42.2±8.5)pg/ml, significantly lower than [(61.3±22.6)pg/ml and (89.1±47.4)pg/ml, respectively, P<0.05] in patients with IR; the abnormal blood coagulation function tests was found in 26 patients out of our series, and all of them were IR patients; the PT, APTT and TT levels in patients with CR were (11.8±1.3) s, (29.6±2.2) s and (15.6±1.2)s, significantly lower than [(13.9±3.6)s, (41.3±6.2)s and (18.9±1.9)s, respectively, P<0.05], while the FIB was (3.1±0.8)g/l, significantly higher than [(3.7±1.2)g/l, P<0.05] in patients with IR; serum CCL4 and CXCL10 levels in patients with normal blood coagulation function tests were (50.2±16.5)pg/ml and (66.3±18.2)pg/ml, significantly lower than [(68.0±24.2)pg/ml and (85.5±39.7)pg/ml, P<0.05] in patients with abnormal blood coagulation function tests. Conclusion Serum chemokines CCL4 and CXCL10 levels in patients with AIH might predict the response to immunosuppression therapy, which needs further clinical trials to verify it.

Key words: Autoimmune hepatitis, Chemokine C-C-motif ligand 4 , C-X-C motif chemokine ligand 10, Coagulation function, Response

肖金玉, 王延峰, 文小霞. 自身免疫性肝炎患者血清趋化因子CCL4和CXCL10水平及其临床意义探讨[J]. 实用肝脏病杂志, 2021, 24(6): 827-830.

Xiao Jinyu, Wang Yanfeng, Wen Xiaoxia. Serum chemokines CCL4 and CXCL10 levels in patients with autoimmune hepatitis[J]. Journal of Practical Hepatology, 2021, 24(6): 827-830.

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