系统检测慢性乙型肝炎患者外周血淋巴细胞免疫表型的临床意义

Clinical values of systemic analysis of peripheral blood mononuclear cell subsets in patients with chronic hepatitis B

目的:系统研究慢性乙型肝炎患者外周血淋巴细胞免疫表型以及与临床的关系.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CD3,CD4,CD5,CD25,CD28及CD38等相关CD分子的表达情况,并与22例健康对照组比较,并分析其与HBVDNA及临床的相关性.结果:28例慢性乙型肝炎患者外周血中CD4+CD25+,CD8+HLADR+CD38+,CD3-CD19+,CD5-CD19+及CD19+CD38+淋巴细胞数明显高于健康对照组(t=2.37,3.71,4.10,2.31,2.17,P<0.05),而CD3-CD8+,CD8+CD28-及CD3-CD(16+56)+淋巴细胞数明显低于健康对照组(t=3.14,3.20,2.51,P<0.05).外周血中HBVDNA含量>109copies/L的患者其CD3+CD8+,CD8+CD28+,CD4+CD45RA+CD62L+,CD8+CD45RA+CD62L+及CD4+CD38+淋巴细胞数均显著高于HBVDNA含量<109copies/L的患者,差别有统计学意义(t=2.16,2.42,2.83,3.01,2.50,P<0.01或P<0.05).结论:慢性乙型肝炎患者T、B两种淋巴细胞的活化程度均较高,NK细胞数量减少;体内HBV复制活跃的患者其T淋巴细胞活化程度较高.

AIM： To study the clinical values of systemic detection for peripheral blood mononuclear cell （PBMC） subsets in patients with chronic hepatitis B （CHB）. METHODS： Flow cytometry （FCM） was used to detect the expression of CD3, CD4, CD5, CD25, CD28 and CD38 in peripheral blood lymphocytes from 28 CHB patients and 22 healthy controls, and their correlations between the quantification of hepatitis B virus （HBV） DNA. RESULTS： The levels of CD4^＋CD25^＋, CD8^＋HLADR^＋CD38^＋, CD3^-CD19^＋, CD5^-CD19^＋ and CD19^＋CD38^＋ lymphocytes in CHB patients with chronic hepatitis B were significantly higher than those in the controls （t = 2.37, 3.71, 4.10, 2.31, 2.17, P 〈 0.05）, while the levels of CD3^-CD8^＋, CD8^＋CD28^- and CD3^-CD（16＋56）^＋ lymphocytes were lower than those in the controls （t = 3.14, 3.20, 2.51, P 〈 0.05）. In the patients with high replication of HBV DNA （more than 109 copies/L）, the numbers of CD3^＋CD8^＋, CD8^＋CD28^＋, CD4^＋CD45RA^＋CD62L^＋, CD8^＋CD45RA^＋CD62L^＋ and CD4^＋CD38^＋ cells were increased dramatically as compared with those in the patients with low HBV replication （t = 2.16, 2.42, 2.83, 3.01, 2.50, P 〈 0.01 or P 〈 0.05）. CONCLUSION： The activation of T and B lymphocytes is up-regulated in the peripheral blood of CHB patients, while the number of natural killer cells is decreased. Meanwhile, the levels of T lymphocytes are increased in patients with high HBV replication.