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慢性乙型肝炎和乙肝肝硬化患者前白蛋白及体重指数变化与T淋巴细胞亚群和营养状况的关系

Changes in Prealbumin and Body Mass Index Associated with T Lymphocyte Subsets and Nutritional Status in Chronic Hepatitis B and HBV-Cirrhosis Patients.

作者信息

Gao Wen, Kong Ming, Yao Jia, Wang Fan, Liu Jing, Wang Dongmei, Ma Hongbo, Ma Lieqing, Duan Zhongping

出版信息

Clin Lab. 2018 Oct 31;64(11). doi: 10.7754/Clin.Lab.2018.180501.

Abstract

Patient immune response is one of the main factors influencing hepatitis virus (HBV) eradication or chronicity. Our study aimed to investigate the relationship between the nutritional status and immune function, and to provide the appropriate clinical diagnosis data for treatment of patients with chronic hepatitis B virus (CHB) and cirrhosis. T lymphocyte subsets were tested using flow cytometry in 100 patients (48 with CHB, 52 with cirrhosis) and 26 healthy individuals. Nutritional parameters were analyzed including body mass index (BMI), blood white blood cell count, albumin, prealbumin, and biochemistry parameters in patient and control groups. Moderate and severe malnutrition (53.84%) were observed in HBV-cirrhosis patients. Serum albumin and prealbumin levels were the lowest in the cirrhosis group. There were significantly lower levels of lymphocyte subsets (CD3+, CD3+CD4+, and CD3+CD8+) in patient groups compared with the control group. There was significantly lower cholesterol, white blood cells, lymphocytes, and platelet levels in the patient group compared with the control group. Interrelation between nutritional and immune parameters showed that serum prealbumin levels were negatively correlated with CD3+, CD3+CD4+, and CD3+CD8+ count in the CHB group, and the immune parameters (CD3+, CD3+CD4+, and CD3+CD8+ count) correlated significantly with BMI in the patients with cirrhosis (r > 0.45). Our data demonstrate that there is a correlation between nutrition deficiency and immune dysfunction in patients with CHB and cirrhosis. It is necessary to assess the nutritional status and immune balance in these patients.

摘要

患者免疫反应是影响肝炎病毒(HBV)清除或慢性化的主要因素之一。我们的研究旨在探讨营养状况与免疫功能之间的关系,并为慢性乙型肝炎病毒(CHB)和肝硬化患者的治疗提供合适的临床诊断数据。采用流式细胞术检测了100例患者(48例CHB患者,52例肝硬化患者)和26名健康个体的T淋巴细胞亚群。分析了患者组和对照组的营养参数,包括体重指数(BMI)、血白细胞计数、白蛋白、前白蛋白以及生化参数。在HBV肝硬化患者中观察到中度和重度营养不良(53.84%)。肝硬化组血清白蛋白和前白蛋白水平最低。与对照组相比,患者组淋巴细胞亚群(CD3+、CD3+CD4+和CD3+CD8+)水平显著降低。与对照组相比,患者组胆固醇、白细胞、淋巴细胞和血小板水平显著降低。营养参数与免疫参数之间的相关性显示,CHB组血清前白蛋白水平与CD3+、CD3+CD4+和CD3+CD8+计数呈负相关,肝硬化患者免疫参数(CD3+、CD3+CD4+和CD3+CD8+计数)与BMI显著相关(r>0.45)。我们的数据表明,CHB和肝硬化患者存在营养缺乏与免疫功能障碍之间的相关性。有必要评估这些患者的营养状况和免疫平衡。

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