【摘要】 目的通过研究肝内CD68+和TNF-α阳性细胞的表达,来探讨它们在乙型肝炎慢加急性肝衰竭(ACLF)发病机制中的作用。方法采用免疫组化法检测乙型肝炎ACLF患者、慢性乙型肝炎(CHB)患者及正常对照人群肝内TNF-α的表达以及其分泌细胞CD68+细胞的数量。结果ACLF患者肝内TNF-α阳性分泌细胞平均数为90/高倍视野(hpf),明显高于CHB患者及正常对照组(分别为12/hpf和5/hpf),差异均非常显著(P<0.001);ACLF患者肝内CD68+细胞平均数为94/hpf,明显高于CHB患者及正常对照组(分别为48/hpf和15/hpf),差异均非常显著(P<0.001);TNF-α阳性分泌细胞与CD68阳性细胞数量具有显著的正相关(r=0.866,P<0.001)。结论乙型肝炎ACLF患者肝内CD68+细胞数量明显增加,其分泌的TNF-α也明显增加,推测TNF-α可能参与了乙型肝炎ACLF的发病过程。更多还原

【Abstract】 Objective To determine the expression of intrahepatic proinflammatory TNF-α as well as its secreting cells(CD68+ cells)to evaluate their roles in the pathogenesis of acute-on-chronic liver failure(ACLF).Methods The expressions of TNF-α,and CD68+ cells were analyzed in the livers of patients with ACLF,chronic hepatitis B(CHB),and normal controls(NC)by using immunohistochemistry.Results The numbers of TNF-α positive cells found in ACLF patients were significantly higher than those in patients with CHB or NC(both P<0.001);ACLF patients exhibited significantly increased numbers of CD68 positive cells as compared to CHB or NC groups(P<0.001);The numbers of intrahepatic TNF-α positive cells were positively correlated with the numbers of CD68-positive cells(r=0.866,P<0.001).Conclusions The significant expression of proinflammatory TNF-α and increased accumulation of CD68 positive cells may contribute to the pathogenesis of ACLF in HBV-infected patients.更多还原