HBV感染对人体T细胞免疫功能影响的研究

The effects of HBV infection on the ability of cellular immunity in human body

目的:通过检测乙型肝炎病毒(HBV)感染后外周血及感染肝组织内CD4+T和CD8+T细胞的数量及功能,探讨HBV对人体T细胞免疫的影响及其可能机制。方法:(1)用流式细胞仪检测36例HBV感染者和20例正常人外周血中T细胞亚群的数量。(2)用免疫组化S-P法检测64例慢性肝病的肝脏标本的HBsAg和HBcAg,将HBsAg和(或)HBcAg阳性的50例作为HBV感染组,而将肝组织HBsAg和HBcAg及血清病原学检查均为阴性的10例作为非HBV感染组(HBV阴性组)。检测其中CD4、CD8、CD25表达情况。结果:(1)HBV感染组外周血T细胞亚群测定值中,CD4+T细胞和CD4+T/CD8+T比值明显低于对照组(Pb<0.05);CD8+T细胞升高,明显高于对照组(Pb<0.05);(2)肝组织内浸润的淋巴细胞主要聚集在汇管区和小叶坏死区,免疫组化结果显示HBV感染组肝组织内的CD8+T和CD4+T细胞数量多于非HBV感染组,统计学上其差异有非常显著意义(Pc<0.01)。HBV感染组肝组织内与T细胞活性有关的CD25+T细胞数量与对照组相比有所减少,但统计学上无显著意义。结论:乙型肝炎病毒感染者外周血和肝内的T细胞亚群紊乱,且活性可能有下降,免疫功能受损。

Objective ：To study the probable mechanism of HBV effect on cellular immune system in human body by detecting the quantity and function of CD4^＋ T and CD8^＋ T cells in peripheral blood and liver tisues. Methods ： 1 ） The quantity of CD4^＋ T and CD8^＋T cells in peripheral blood was detected by flow cytometry（FCM） in 36 patients with hepatitis B and 20 cases of controls;2）The expressions of HBsAg and HBcAg were detected by streptavidin - peroxidase inmmnohistochemistry （SP）. 50 cases of positive HBsAg and（or）HBcAg were selected as HBV（ ＋ ） group,and 10 cases of negative HBsAg and HBcAg in liver tissue and blood serum were selected as HBV（ - ） group. The expressions of CD4,CD8,CD25 in liver tiasues were detected in the two groups. Results ： 1 ）The quantity of CD4^＋ T cells and the ratio of CD4^＋ T/CD8^＋ T in peripheral blood of patients was significantly lower than those in controls; the quantity of CD8^＋ T cells was considerably higher than that in controls. （2）T lymphoid cell infiltrates in the liver were most gathered in the lobules and the portal tract. The densities of CD8^＋ T cells were higher in lobules and portal tracts than CD4^＋ T cells.The quantity of CD8^＋ T and CD4^＋T cells in the liver tissues of HBV positive group showed significant difference from the liver tissues of HBV negative group（ P^b〈 0.05 ）. The quantity of CD25^＋ T related to ability of immunity in HBV positive group was less than HBV negative group, but no significant statistical difference was found between two groups. Conclusion ： The T lymphoid subsets of peripheral blood mononuclear cells and the liver tissues of patients infected with HBV are disordered and the activity of T cells decreases, which suggests a possible weakened immunity.