BackgroundRecent studies have shown that T cell-mediated cellular immune mechanisms play important roles in the progression of hepatitis B to liver cirrhosis, but the underlying mechanisms remain unclear. This present study was aimed to determine the relationship between Treg/Th17 and hepatitis B-associated liver cirrhosis.MethodsThe Treg and Th17 cell frequencies in the peripheral blood of all participants, including 93 patients with hepatitis B-associated liver cirrhosis and 40 healthy subjects, were measured by flow cytometer. Cox regression model and receiver operating characteristic(ROC) curves were applied to investigate the prognostic significance of Treg/Th17 ratio in decompensated liver cirrhosis.ResultsWe observed the Treg/Th17 imbalance was present in patients with hepatitis B-associated liver cirrhosis, with reduced Treg cells in their peripheral blood, increased Th17 cells and decreased Treg/Th17 ratio. Treg and Th17 cells were negatively correlated. Treg/Th17 imbalance was closely related to the clinical stage of hepatitis B-associated liver cirrhosis. The Virus load, Treg frequencies and the Treg/Th17 ratio were independent factors predicting decompensated liver cirrhosis from a Cox regression model. The ROC analysis showed that the Treg/Th17 ratio was the best marker for predicting decompensated liver cirrhosis.ConclusionsTreg/Th17 imbalance is involved in the pathogenesis of hepatitis B-associated liver cirrhosis and the Treg/Th17 ratio can be used as a potential marker for predicting decompensated liver cirrhosis.
The identification significance of C-reactive protein (CRP) and procalcitonin (PCT) levels in the intensive care unit patients with combined infection and their prognostic effects of patients with sepsis was investigated. A total of 203 patients were divided into the sepsis (n=60) and the non-sepsis group (n=143). The predictive effects of CRP and PCT levels in patients in the intensive care unit on sepsis and their effects on the prognosis of patients with sepsis were analyzed. The results showed that CRP and PCT levels in patients in the sepsis were higher than those in the non-sepsis group (P<0.05); CRP and PCT levels in patients who died of sepsis at 1 week and 2 weeks after admission were not statistically different to those before admission (P>0.05); CRP and PCT levels in patients surviving sepsis at 1 week after admission were significantly decreased compared with those at admission (P<0.05). CRP and PCT levels in patients at 2 weeks after admission were significantly decreased compared with those at admission (P<0.05). CRP and PCT levels in patients who died of sepsis were higher than those surviving sepsis (P<0.05). Logistic regression analysis showed that the higher the CRP and PCT levels were, the worse the patients' conditions would be, and the higher the risk of death would be (r=0.732, P=0.012; r=0.826, P=0.007); besides, PCT had a higher value in predicting the poor prognosis of patients [PCT: Area under the curve (AUC)=0.734, CRP: AUC=0.699]; the univariate Cox regression analysis revealed that CRP, PCT and age may be the risk factors for poor prognosis in patients. CRP and PCT can be used to identify whether the patients in the intensive care unit are infected or not. The dynamic monitoring of CRP and PCT has important clinical significance in predicting the prognosis of patients with sepsis.
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