目的 研究乙型肝炎慢加急性肝衰竭(ACLF)患者肝内促炎细胞因子和抗炎细胞因子的表达特性.方法 采用免疫组化法检测乙型肝炎ACLF患者、慢性乙型肝炎患者和正常人肝组织IFN-γ、TNF-α和IL-10的表达.结果 在ACLF患者肝组织IFN-γ和TNF-α阳性细胞数均明显高于慢性乙型肝炎患者和正常对照组(P均<0.001);ACLF患者、慢性乙型肝炎患者和正常人肝组织IL-10的表达无统计学差异(P>0.05);肝内IFN-γ表达与TNF-α具有明显的相关性(r=0.886,P<0.001).结论 乙型肝炎ACLF患者因肝内促炎细胞因子和抗炎细胞因子表达的失衡而发生了肝损伤.%Objectives This study attempted to determine intrahepatic expressions of proinflammatory and anti-inflammatory cytokines in patients with acute-on-chronic liver failure (ACLF)arosing from HBV infection. Methods In situ expressions of interferon(IFN- γ ) , tumor necrosis factor( TNF- α )and interleukin 10 ( IL-10 )were analyzed in the livers of patients with ACLF,chronic hepatitis B (CHB),and normal controls (NC)by using immunohistochemistry. Results Intrahepatic IFN- γ and TNF- α expressions were markedly up-regulated in patients with ACLF as compared to CHB and NC(both P<0.001);However,similar IL-10 expressions were ohserved in ACLF and CHB;IFN -γ over-expression was actively correlated with expression of TNF-α (r=0.886,P<0.001).Conclusions The imbalanced expression of proinflammatory and anti-inflammatory cytokines may contribute to immuno-pathogenesis in HBV-infected ACLF.
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