本文關(guān)鍵詞： 慢性乙型重型肝炎 Th17細(xì)胞 Treg細(xì)胞　出處：《泰山醫(yī)學(xué)院》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的 探討慢性乙型重型肝炎和慢性乙型重度肝炎患者外周血中Th17細(xì)胞和Treg細(xì)胞及其相關(guān)因子表達(dá)水平間的關(guān)系。 方法 選擇2010年1月～2012年6月我院收治的26例慢性乙型重型肝炎患者和20名慢性乙型重度肝炎患者作為研究對象；采集患者靜脈血，采用流式細(xì)胞儀檢測兩組患者外周血Th17/Treg、Th17/CD4+T細(xì)胞和Treg/CD4+T細(xì)胞；應(yīng)用RT-PCR檢測外周血PBMC中RORγt和FOXP3mRNA表達(dá)水平；采用ELASE法檢測患者外周血中PBMC細(xì)胞培養(yǎng)上清中IL-17和TGF-β含量。 結(jié)果 1.慢性乙型重型肝炎組患者Th17/Treg、 Th17/CD4+T和Treg/CD4+T分別為5.18、4.29和5.6，慢性乙型重型肝炎組患者Th17/Treg、Th17/CD4+T和Treg/CD4+T分別為2.01、1.08和6.92，兩組間比較差異具有統(tǒng)計學(xué)意義（P0.05）。 2.慢性乙型重型肝炎組患者RORγt和FOXP3濃度分別為0.528、0.516μg/μl，慢性乙型重度肝炎組分別為0.504、0.522μg/μl，兩組樣本濃度間比較差異無統(tǒng)計學(xué)意義（P0.05）；RORγt純度分別為1.842和1.828，F(xiàn)OXP3純度分別為1.881和1.834，均處于1.8～2.0范圍內(nèi)，各樣本總RNA濃度和純度滿足實驗要求；紫外透射儀下電泳條帶上有三條清晰的帶，，說明RNA完整性較好�；颊咄庵苎狿BMC經(jīng)培養(yǎng)后，RORγt和FOXP3mRNA表達(dá)量，慢性乙型重型肝炎組分別為1.08和0.70，慢性乙型重度肝炎組分別為0.65和1.18，兩組之間有統(tǒng)計學(xué)差異（P0.05）。 3.外周血PBMC培養(yǎng)上清液中IL-17和TGF-β含量，慢性乙型重型肝炎組患者分別為41.60pg/ml和256.19pg/ml，慢性乙型重度肝炎組患者分別為32.48pg/ml和299.37pg/ml，兩組之間有顯著統(tǒng)計學(xué)差異（P0.01）。 結(jié)論 慢性乙型重型肝炎患者外周血Th17細(xì)胞被激活而Treg細(xì)胞被抑制；Th17/CD4+T顯著升高、Treg/CD4+T顯著降低，轉(zhuǎn)錄因子RORγt mRNA表達(dá)增加而FOXP3mRNA表達(dá)減少，IL-17水平升高而TGF-β水平降低，引起體內(nèi)免疫抑制效應(yīng)減弱、免疫炎性效應(yīng)增強(qiáng)，導(dǎo)致肝臟炎癥活動加劇，最終發(fā)展為重型肝炎。
[Abstract]:Purpose. To investigate the relationship between the expression levels of Th17 cells, Treg cells and related factors in peripheral blood of patients with chronic severe hepatitis B and severe hepatitis B. Method. From January 2010 to June 2012, 26 patients with chronic severe hepatitis B and 20 patients with severe chronic hepatitis B were selected as study subjects. The levels of ROR 緯 t and FOXP3mRNA in peripheral blood PBMC were detected by RT-PCR, and IL-17 and TGF- 尾 in the supernatant of PBMC cells in peripheral blood were detected by ELASE method. Results. 1. Th17 / Tregt Th17 / CD4 T and Treg/CD4 T were 5.184.29 and 5.6 in patients with severe hepatitis B, respectively, and Th17 / Tregt Th17 / CD4 T and Treg/CD4 T in patients with severe hepatitis B were 2.011.08 and 6.92, respectively. There was a significant difference between the two groups (P 0.05). 2. The concentrations of ROR 緯 t and FOXP3 in patients with severe hepatitis B were 0.528 渭 g / 渭 l and 0.504 渭 g / 渭 l, respectively. There was no significant difference in the purity of ROR 緯 t between the two groups. The purity of ROR 緯 t was 1.881 and 1.834, respectively, in the range of 1.82.0. The total RNA concentration and purity of each sample met the experimental requirements, and there were three clear bands on the electrophoresis band under UV transmission instrument, which indicated that the integrity of RNA was better. The expression of ROR 緯 t and FOXP3mRNA in peripheral blood PBMC of patients was increased after culture. The chronic severe hepatitis B group was 1.08 and 0.70, and the chronic severe hepatitis B group was 0.65 and 1.18 respectively. There was significant difference between the two groups (P 0.05). 3. The levels of IL-17 and TGF- 尾 in the supernatant of peripheral blood PBMC culture were 41.60 PG / ml and 256.19 PG / ml in patients with severe hepatitis B and 32.48 PG / ml and 299.37 PG / ml in patients with severe hepatitis B, respectively. There was a significant difference between the two groups (P0.01). Conclusion. In patients with severe hepatitis B, Th17 cells in peripheral blood were activated but Treg cells were inhibited. Th17 / CD4 T was significantly increased. The expression of transcription factor ROR 緯 t mRNA was increased, and the expression of FOXP3mRNA was decreased. The level of IL-17 was increased and the level of TGF- 尾 was decreased. The immunosuppressive effect in vivo is weakened, and the immune inflammatory effect is enhanced, leading to the intensification of inflammatory activity in the liver, which eventually develops into severe hepatitis.
【學(xué)位授予單位】：泰山醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R512.62

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