急性药物性肝损伤患者外周血单核细胞百分比的变化

摘要/Abstract

摘要： 目的探讨急性药物性肝损伤患者外周血单核细胞百分比的变化。方法回顾性收集2015年1月至2022年12月在大理大学第一附属医院消化内科确诊为急性药物性肝损伤患者的临床资料,共入组185例,按肝损伤生化异常类型分为肝细胞损伤型124例、胆汁淤积型27例、混合型34例;按严重程度分为轻度103例、中度71例、重度11例,统计分析各组外周血单核细胞百分比。结果 185例外周血单核细胞百分比平均为10.81%,明显高于正常范围。其中,142例(76.76%)单核细胞百分比升高,43例(23.24%)单核细胞百分比不升高。肝细胞损伤型、胆汁淤积型、混合型外周血单核细胞百分比分别为11.37%±3.70%,9.95%±2.06%,9.40%±3.30%;肝细胞损伤型单核细胞百分比高于胆汁淤积型和混合型,差异有统计学意义(P=0.008;P=0.006),胆汁淤积型和混合型单核细胞百分比比较,差异无统计学意义(P=0.454)。轻度组、中度组、重度组外周血单核细胞百分比分别为10.12%±3.49%、11.69%±3.50%、11.85%±2.66%;轻度组外周血单核细胞百分比低于中度组,差异有统计学意义(P=0.004),轻度组和重度组、中度组和重度组单核细胞百分比差异无统计学意义(P=0.131;P=0.887)。结论大部分急性药物性肝损伤患者外周血单核细胞百分比明显高于正常范围,肝细胞损伤型单核细胞百分比高于胆汁淤积型和混合型,轻度组外周血单核细胞百分比低于中度组,轻度组和重度组、中度组和重度组差异无统计学意义,可能与重度病例少有关。临床中急性不明原因肝损伤患者外周血单核细胞百分比升高,应考虑是否为药物性肝损伤。

关键词: 药物性肝损伤, 单核细胞百分比, 临床研究

Abstract: Objective To explore the changes in the percentage of peripheral blood mononuclear cells in patients with acute drug-induced liver injury. Methods The clinical data of patients diagnosed with acute drug-induced liver injury in the First Affiliated Hospital of Dali University from January 2015 to December 2022 were retrospectively collected. 185 cases were enrolled and the percentage of peripheral blood mononuclear cells was analyzed. In total 185 cases,there were 124 cases of hepatocyte injury type,27 cases of cholestasis type, 34 cases of mixed type; there were 103 cases of mild type, 71 cases of moderate type, and 11 cases of severe type. The percentage of peripheral blood mononuclear cells in each group was statistically analyzed. Results The average percentage of peripheral blood monocytes among 185 patients was 10.81%, which was significantly higher than healthy person. Among the 185 cases, 76.76% (142 cases) had elevated monocyte percentage, while 23.24% (43 cases) were not. The percentages of peripheral blood mononuclear cells in the hepatocellular injury type, cholestatic type, and mixed type were 11.37%±3.70%, 9.95%±2.06%, and 9.40%±3.30% respectively. The percentage of monocytes in the hepatocellular injury group was higher than cholestasis group and mixed group(P=0.008; P=0.006), and there was no statistically significant difference between cholestasis group and mixed group (P=0.454); the percentages of peripheral blood mononuclear cells in the mild group, moderate group, and severe group were 10.12%±3.49% 11.69%±3.50%, 11.85%±2.66% respectively; the percentage of peripheral blood mononuclear cells in the mild group was lower than that in the moderate group (P=0.004). There was no statistical difference between the mild group and the severe group, and there was no statistical difference between the moderate group and the severe group (P=0.131; P=0.887). Conclusion The percentage of peripheral blood mononuclear cells in most patients with acute drug-induced liver injury is significantly higher than healthy person. The percentage of mononuclear cells in the hepatocyte injury type is higher than that in the cholestatic and mixed types. The percentage of peripheral blood mononuclear cells in the mild group is lower than that in the moderate group. There is no statistically significant difference between mild group and severe group, moderate group and severe group, which may be due to the small number of severe cases. Patients with acute unexplained liver injury may be accompanied with increased percentage of peripheral blood mononuclear cells.

Key words: Drug-induced liver injury, Monocyte percentage, Clinical investigation

杨波, 姚秋艳, 吴泽生. 急性药物性肝损伤患者外周血单核细胞百分比的变化[J]. 肝脏, 2025, 30(11): 1554-1556.

YANG Bo, YAO Qiu-yan, WU Ze-sheng. The percentage of peripheral blood mononuclear cells increased in patients with acute drug-induced liver injury[J]. Chinese Hepatolgy, 2025, 30(11): 1554-1556.

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