Clin Gastroenterology H:肝硬化急性失代偿患者促炎介质水平与3个月死亡率相关

2020-05-01 MedSci原创 MedSci原创

严重感染是肝硬化患者的常见死亡原因。本项研究旨在探究住院三个月内先天性免疫反应与肝硬化失代偿患者死亡之间的关系。

背景与目标: 严重感染是肝硬化患者的常见死亡原因。本项研究旨在探究住院三个月内先天性免疫反应与肝硬化失代偿患者死亡之间的关系。

方法:研究人员在第1、5、10和15天,从招募入白蛋白的参与者收集血浆样本,以研究预防慢性肝衰竭中的感染情况。急性失代偿性肝硬化患者接受了白蛋白输注。本项研究共纳入45名长期幸存者和27名非幸存者。研究人员将来自健康个体的单核细胞衍生的巨噬细胞与患者的血浆样品一起孵育,并测量了脂多糖给药后的活化情况,该活化由肿瘤坏死因子的分泌和炎症的可溶性介质确定。

结果:幸存者和非幸存者的血浆样本具有不同的炎症特征。住院患者时前列腺素E2的水平较高,而输注白蛋白则降低。治疗第5天时血浆中白介素4(IL4)水平升高与3个月生存时间相关。将单核细胞衍生的巨噬细胞与来自幸存者的第5天血浆一起孵育,然后将其与针对IL4的中和抗体一起预孵育,从而使肿瘤坏死因子的产生显着增加至非幸存者血浆的水平。尽管基线特征相似,但非幸存者的白细胞计数和C反应蛋白水平及肾功能不全更高。

结论:肝硬化失代偿患者血浆中炎症标志物与3个月死亡率相关。前列腺素E2的增加可能会在住院后的几天内促进炎症,并且在第5天血浆IL4的水平升高与生存期增加相关。

原始出处:

Natalia Becares. Et al. Immune Regulatory Mediators in Plasma from Patients With Acute Decompensation Are Associated With 3-Month Mortality. Clin Gastroenterology H.2020.

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    2020-05-01 guging

    谢谢!最新的信息读起来就是收获大

    0

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