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摘要：
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摘要：目的 探讨非酒精性脂肪性肝病（non-alcoholic fatty liver disease，NAFLD）患者外周血缺氧诱导
因子-1α（hypoxia-inducible factor-1α，HIF-1α）、调节性T细胞（regulatory T cell，Treg cell）和辅助性
T细胞17（T helper cell 17，Th17 cell）与炎性细胞因子水平及其相关性。方法 选取2018年4月至2019年
9月三亚市人民医院收治的55例NAFLD患者为研究组，另选取同期于本院进行健康体检的50例健康人
群为对照组。采用酶联免疫吸附实验（enzyme linked immunosorbent assay，ELISA）检测血清HIF-1α、
白细胞介素（interleukin，IL）-10、IL-17、IL-23及转化生长因子-β1（transforming growth factor-β1，
TGF-β1）水平。采用流式细胞术检测CD4 + T淋巴细胞中Treg细胞和Th17细胞所占比例。炎性细胞因
子水平与外周血HIF-1α、Treg细胞、Th17细胞、Th17/Treg的相关性采用Pearson相关性分析。结果 研
究组患者外周血HIF-1α水平显著高于对照组[（61.21 ± 11.68）μg/L vs（25.13 ± 4.07）μg/L]，差
异有统计学意义（t = 12.726，P = 0.021）。研究组患者外周血Th17细胞[（4.84 ± 1.28）% vs（1.23 ±
0.30）%]、Treg细胞[（5.41 ± 1.39）% vs（2.24 ± 0.86）%]及Th17/Treg（0.99 ± 0.30 vs 0.60 ± 0.11）水平
均显著高于对照组，差异有统计学意义（t值分别为17.596、13.204、6.819，P值分别为0.006、0.012、
0.038）。研究组患者血清IL-10 [（20.91 ± 4.05）ng/L vs（14.15 ± 2.93）ng/L]、IL-17 [（23.26 ± 3.90）ng/L vs
（5.24 ± 0.67）ng/L]、IL-23 [（234.32 ± 59.64）ng/L vs（100.03 ± 31.58）ng/L]及TGF-β1 [（7.17 ± 1.22）ng/L vs
（4.28 ± 1.04）ng/L]水平均显著高于对照组，差异有统计学意义（t值分别为8.132、15.538、23.597、
7.004，P值分别为0.028、0.009、0.001、0.033）。NAFLD患者血清中IL-10、IL-17、IL-23、TGF-β1
水平与外周血Treg细胞、Th17细胞、Th17/Treg均呈正相关（P ＜ 0.001）。结论 NAFLD患者外周血
HIF-1α、Treg细胞、Th17细胞、Th17/Treg与炎性细胞因子水平（IL-10、IL-17、IL-23、TGF-β1）显
著升高。HIF-1α、Treg细胞、Th17细胞、Th17/Treg和炎性细胞因子及其相互作用可能是NAFLD发生
发展的影响因素。
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Abstract: Objective To investigate the changes and correlation of hypoxia-inducible factor-1α (HIF-1α),
regulatory T cell (Treg cell), helper T cell 17 (Th17 cell) and inflammatory cytokines in peripheral blood of
patients with non-alcoholic fatty liver disease (NAFLD). Methods A total of 55 patients with NAFLD in
Sanya People’s Hospital from April 2018 to September 2019 were selected as study group. Another 50 healthy
people who had physical examination in our hospital at the same time were selected as control group. Enzyme
linked immunosorbent assay (ELISA) was used to detect the serum levels of HIF-1α, interleukin (IL)-10, IL-
17, IL-23 and transforming growth factor-β1 (TGF-β1). Flow cytometry was used to detect the proportion
of Treg cell and Th17 cell in CD4 + T lymphocytes. The correlation between inflammatory cytokine levels
and HIF-1α, Treg cell, Th17 cell and Th17/Treg in peripheral blood were analyzed by Pearson correlation.
Results The levels of HIF-1α in peripheral blood of patients in study group was significantly higher than that
in control group [(61.21 ± 11.68) μg/L vs (25.13 ± 4.07) μg/L], the difference was statistically significant (t =
12.726, P = 0.021). The levels of Th17 cell [(4.84 ± 1.28)% vs (1.23 ± 0.30)%], Treg cell [(5.41 ± 1.39)% vs
(2.24 ± 0.86)%] and Th17/Treg (0.99 ± 0.30 vs 0.60 ± 0.11) in the peripheral blood of patients in study group
were significantly higher than those in control group, the differences were statistically significant (t = 17.596,
13.204, 6.819; P = 0.006, 0.012, 0.038). The levels of IL-10 [(20.91 ± 4.05) ng/L vs (14.15 ± 2.93) ng/L],
IL-17 [(23.26 ± 3.90) ng/L vs (5.24 ± 0.67) ng/L], IL-23 [(234.32 ± 59.64) ng/L vs (100.03 ± 31.58) ng/L]
and TGF-β1 [(7.17 ± 1.22) ng/L vs (4.28 ± 1.04) ng/L] in serum of patients in study group were significantly
higher than those in control group, the differences were statistically significant (t = 8.132, 15.538, 23.597, 7.004;
P = 0.028, 0.009, 0.001, 0.033). The serum IL-10, IL-17, IL-23, TGF-β1 levels of patients with NAFLD were
positively correlated with Treg cell, Th17 cell and Th17/Treg in peripheral blood (P ＜ 0.001). Conclusions
The levels of HIF-1α, Treg cell, Th17 cell, Th17/Treg and inflammatory cytokines like IL-10, IL-17, IL-23 and
TGF-β1 increased significantly in patients with NAFLD. HIF-1α, Treg cell , Th17 cell , Th17/Treg, inflammatory
cytokines and their interreaction may be the factors that induce the occurrence and development of NAFLD.
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