慢性乙型肝炎患者B淋巴细胞及其活化状况对治疗和预后的影响

Role of B lymphocytes in patients with chronic hepatitis B

目的研究慢性乙型肝炎患者B淋巴细胞及其活化状况以及与临床的关系。方法用流式细胞术测定28例慢性乙型肝炎患者外周血单个核细胞膜CD5、CD19、CD23及CD38的表达情况,用速率散射比浊法测定其血清IgGI、gAI、gM含量,并与22例健康对照组比较。结果28例慢性乙型肝炎患者外周血中CD3-CD19+、CD5-CD19+及CD19+CD38+淋巴细胞数分别为(13.2±5.7)%、(4.3±3.8)%及(2.2±4.4)%,明显高于健康对照组,差别具有统计学意义(t=4.10、2.31、2.17,P<0.05)。B淋巴细胞活化程度与血清免疫球蛋白含量具有显著相关性。外周血中B淋巴细胞数较高的慢性乙型肝炎患者肝功能指标(ALT)的恢复情况较好。结论慢性乙型肝炎患者B淋巴细胞的活化程度较高,活化的B淋巴细胞可能通过体液免疫改善患者的肝功能。

Objective To study the relation between the activation status of B lymphocytes and the hepatic function improvement of chronic hepatitis B virus（HBV） patients. Methods The expressions of CD5,CD19,CD23 and CD38 in peripheral blood lymphocytes from 28 HBV patients and control group （22 healthy people） were analyzed by flow cytometry（FCM）, and the serum IgG, IgA, IgM levels from 28 HBV patients were determined by scattering nephelometry. Results CD3^-CD19^＋ ,CD5^- CD19^＋ and CD19^＋ CD38^＋ expressions in peripheral blood lymphocytes from 28 HBV patients [（ 13.2± 5.7 ） %, （ 4.3 ± 3.8） % and （ 2.2 ± 4.4） %] were significantly higher than those of control group（ t =4.10,2.31,2.17, P 〈d0.05）. There was a positive correlation between the levels of CD5^- CD19^＋ , CD19^＋ CD38^＋ expressions in peripheral blood lymphocytes and those of serum IgG,IgA,IgM. With the expression of CD5^- CD19^＋ and CD19^＋ CD38^＋ increased, one of liver function indexe（ALT）as gradually decreased in HBV patients. Conclusion The activation levels of B lymphocytes of the patients with HBV hepatitis B were higher than those of control group, and the higher activated B lyrnphocytes may be helpful to improve the liver function.