| Objective:To investigate the abnormal immune function and biochemical indexes in patients with primary biliary cholangitis(PBC),and to analyze the correlation between bile acid and immune function and biochemical indexes,so as to provide clinical basis for the diagnosis and treatment of PBC disease.Methods:The clinical data,laboratory data and auxiliary examination of 49 primary biliary cholangitis patients with complete information and treated in the second Hospital of Shanxi Medical University were collected.According to their pathological examination and clinical stage,49 patients were divided into PBC I(n = 7),II(n = 16),III(n = 16)and IV(n = 10),and 53 healthy persons with complete data in our hospital in the same period were selected as the control group.Detection liver function: ALT,AST,TBIL,DBIL,IBIL,ALP,GGT,TBA,blood lipids: CHO,TG,HDL-C,LCL-C,peripheral blood lymphocyte subsets: t lymphocytes(CD3+CD19-),B lymphocytes(CD3-CD19+),Th cells(CD3+CD4+),Ts cells(CD3+CD8+),CD4+T lymphocyte subsets: Th1 cells,Th2 cells,Th17 cells,Treg cells.Cytokines: IL-2,IL-4,IL-6,IL-10,IL-17,INF-γ,TNF-α.The results were analyzed by SPSS 22.0 software.Results:1.There was no significant difference in age and sex between the PBC group and the control group(P>0.05).2.ALT,AST,TBIL,IBIL,ALP,GGT,TBA and LDL-C in PBC group were higher than that in control group,with statistically significant differences.[PBC group: control group,ALT:35.2(18.4,45.4):23.8(11.7,30.6),p<0.001,AST:34.3(25.25,57.75):26.5(18.45,33.35),p<0.001、TBIL:14.6(12.2,20.1):11.2(9.05,15.5),p<0.001,IBIL:11.7(9.25,15.6):6.1(3.4,11.9),p<0.001、ALP:178(97.5,270.5):65.7(52.65,80.35),p < 0.001,GGT : 100.5(31.3,254.95): 24.1(14.6,33.00),p < 0.001 、 TBA: 15.4(8.1,23.05):4.16(1.88,6.51),p<0.001、LDL-C:2.03(1.58,2.57):1.80(0.96,2.48),p<0.001].3.Th1,IL-2,IL-4,IL-6,IL-10,IL-17,INF-γ and TNF-α in PBC group were higher than those in control group,while T cells,NK cells,Th2 and Treg were lower than those in control group,with statistically significant differences.[PBC group: control group,Th1:115.60(61.62,211.90): 42.10(9.34,104.50),p < 0.001 、 IL-2 : 3.10(2.12,5.68):1.4(1.07,1.90),p<0.001,IL-4:2.95(1.44,5.24):0.22(0.15,1.00),p<0.001、IL-6:9.65(5.51,42.89):1.9(1.50,2.10),p<0.001,IL-10:6.70(4.10,15.84):1.1(0.50,1.50),p<0.001,IL-17:14.54(7.07,20.96):2.7(1.50,4.80),p<0.001,INF-γ:5.82(3.88,17.07):1.1(0.40,2.30),p < 0.001 、 TNF-α : 9.14(3.02,15.58): 0.9(0.40,1.30),p < 0.001,T :1050.49(602.68,1415.46): 1263(1089.5,1608),p=0.009,NK : 138.15(67.56,241.11):259.34(180.5,310.5),p<0.001、Th2:5.51(2.87,9.125):10.18(5.37,15.40),p=0.001,Treg:22.67(14.78,34.78):32.67(24.57,41.95),p<0.001]4.The levels of ALT,AST,TBIL,DBIL,ALP,GGT and TBA in the late stage of PBC were higher than those in the early stage,and the LDL-C was lower than that in the early stage,with statistically significant differences.[late stage of PBC:Early stage of PBC,ALT:41.15(27.75,57.77):22.8(15.2,37.5),p=0.010,AST:55.9(32.8,84.12):25.9(22.5,39.8),p<0.001,TBIL:16.5(13.52,24.92):14.1(11.3,16.4),p=0.020,DBIL:3.95(3.22,5.72):2.6(2.1,3.0),p<0.001,ALP:253.5(148.75,478.50):98(88,186),p<0.001,GGT:152.2(54.8,318.55):37.5(25.9,162.5),p=0.007,TBA:20.9(15.1,30.1):7.5(5.7,15.3),p<0.001,LDL-C:1.70(1.26,2.33):2.26(1.91,3.04),p=0.010].5.Spearman rank correlation analysis results:1)Serum total bile acid was positively correlated with T cells(r=0.293,p=0.041),Th cells(r=0.356,p=0.010),Th2 cells(r=0.342,p=0.016)and Treg(r=0.299,p=0.037)in PBC group,with statistically significant differences(P<0.05).2)Serum total bile acid was positively correlated with T cells(r=0.478,p=0.021),Th2cells(r=0.467,p=0.025)and Th17 cells(r=0.455,p=0.029)in early PBC group,with statistically significant differences(P<0.05).3)Serum total bile acid was positively correlated with T cells(r=0.456,p=0.019),B cells(r=0.405,p=0.040)and Th cells(r=0.569,p=0.002)in late PBC group,with statistically significant differences(P<0.05).4)Serum total bile acid in PBC group was positively correlated with ALT(r=0.561,p<0.001),AST(r=0.623,p<0.001),TBIL(r=0.360,p=0.010),DBIL(r=0.507,p<0.001),IBIL(r=0.330,p=0.017),ALP(r=0.935,p<0.001),GGT(r=0.721,p<0.001),CHO(r=0.405,p=0.004)and TG(r=0.300,p=0.034),with statistically significant differences(P<0.05).Conclusion:1.The abnormal immune function of patients with PBC mainly involves T lymphocytes and related cytokines.Bile acid in patients with PBC is also mainly related to T lymphocytes,which can not only cause the accumulation of pro-inflammatory factor Th17 and damage to the liver,but also up-regulate the level of anti-inflammatory factor Treg.By further studying the effects of different bile acid components on immune function,it can provide help for the treatment of PBC.2.Serum total bile acid in patients with PBC is related to a variety of liver injury indicators,and the level of serum total bile acid in patients with advanced PBC is higher than that in early stage,so paying attention to the change of serum total bile acid is helpful to judge the disease progression and prognosis of PBC. |
PDF Full Text Request