目的：探讨乙型肝炎病毒（HBV）相关慢加急性肝衰竭（HBV-ACLF）患者外周血自然杀伤（NK）细胞活化型受体和抑制型受体表达与肝损伤的相关性。方法利用多色流式技术检测20例 HBV-ACLF患者和20例 HBV-慢性乙型肝炎（CHB）患者外周血NK细胞活化型受体（NKP30、NKP46、NKG2D）及抑制型受体（CD158a）的表达频率。结果与 HBV-CHB患者相比，HBV-ACLF患者外周NK细胞活化型受体（NKP30、NKP46）表达均显著上调（P＜0．05），而NK细胞抑制型受体CD158a的表达显著下调（P＜0．05）。结论 NK细胞活化型受体NKP30和NKP46表达的增强及抑制型受体CD158a表达的减弱可能是NK细胞活化及随后 HBV-ACLF免疫介导的肝细胞损伤的重要因素。%Objective To investigate the correlation between the expression of the activating and inhibitory receptors on periph-eral natural killer (NK) cells with the liver injury in the patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF) .Methods The peripheral blood samples were collected from 20 patients with HBV-ACLF and 20 patients with HBV-chro-nic hepatitis B(CHB) .The expressions of the activating receptors (NKP30 ,NKP46 ,NKG2D) and the inhibitory receptor (CD158a) on peripheral NK cells were detected by the multicolor flow cytometry .Results Compared with the HBV-CHB patients ,the ex-pression of the activating receptors NKP30 and NKP46 in the HBV-ACLF were remarkably unregulated(P<0 .05) ,but the expres-sion of the inhibitory receptor CD158a was markedly downregulated(P<0 .05) .Conclusion The enhanced expression of the activa-ting receptors NKP30 and NKP46 and the weakened expression of inhibitory receptor CD158a may be the important factor of the NK cells activation and the subsequent HBV-ACLF immune-mediated hepatocyte injury .
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