CD4^+细胞及相关细胞因子在慢性乙型肝炎患者血中的变化

The changes of CD4^+ cells and relevant cytokines in the blood from chronic hepatitis B patients

目的探讨部分CD4+细胞及相关细胞因子在慢性乙型肝炎患者血中的变化及意义。方法用流式细胞术检测外周血单个核细胞(PBMC)CD4、CD8和CD28分子表达情况;同时检测血清白介素(IL)-2、干扰素(IFN)-γI、L-4I、L-10和IL-12水平以及肝功能。结果与正常对照组相比,86例慢性乙型肝炎患者PBMC CD4+细胞比率呈降低、不变和增高3种状态(定义为3组);而CD28分子的表达与CD4+细胞比率的变化趋势一致;上述血清细胞因子水平除IL-4外,其余均显著增高(P<0.01或P<0.05),但3组间差异无统计学意义;肝功能检测结果显示,部分患者ALT水平有异常,且与CD4+细胞比率呈正相关。结论慢性乙型肝炎患者血中CD4+T细胞比率存在降低、不变和增高的改变;与病毒相关的几种细胞因子水平升高。鉴于ALT水平与CD4+T细胞比率呈正相关,推测乙型肝炎患者肝细胞损伤与CD4+细胞中的细胞毒性T淋巴细胞(CTL)有关。

Objective To explore the changes of CD4^＋ cell and relevant cytokines from chronic hepatitis B patients and the significance was discussed. Methods The expression of CD4, CD8 and CD28 molecules on PBMC was detected with Flow Cytometry. The levels of IL-2, IFN-γ, IL-4, IL-10 and IL-12 in serum were measured with ELISA, and the liver function test including serum ALT, SB, ALP and albumin was conducted. Results Three conditions of CD4^＋ ratio from PBMC in 86 patients were observed, that showed lower, similar or higher comparing with normal controls. According to CD4^＋T cell ratio, the patients were divided into 3 groups. In three groups ,the changes of CD28 expression paralleled to that of CD4^＋ T cell ratio. Except IL-4, the level of cytokines related to viral clearance such as IL-2, IFN-γ, IL-10 and IL-12 in patients was elevated compared with controls（P〈0.01）. ALT levels were abnormal only in part of patients and its value was positively correlated with CD4^＋T cell ratio. Conclusions The CD4^＋T cell ratio in patients with chronic hepatitis B was different that showed lower, similar or higher compared with that in controls. And these differences were correlated to ALT level which suggested that the damage of liver cells may related to CTL activities among CD4^＋ cells.