慢性乙型肝炎 e 抗原阳性和阴性患者细胞免疫功能的研究

Study of cell-mediated Immunologic Function in HBeAg-Positive and Negative Patients with Chronic Hepatitis B

目的：进一步探讨ｅ系统在慢性乙肝病情评估中的意见。方法：慢性乙型肝炎患者５９例，其中ＨＢｅＡｇ阳性者２８例，抗ＨＢｅ阳性者１９例，ＨＢｅＡｇ／抗－ＨＢｅ阴性者１２例。正常对照９例。采用间接夹心ＥＬＩＳＡ法检测血清ＩＬ－２水平，用ＡＰＡＡＰ法检测外周血Ｔ细胞亚群，并动态观察８例ＨＢｅＡｇ阳性患者向ｅ系统阴性转化过程中的ＩＬ－２水平、ＡＬＴ水平及ＨＢＶ－ＤＮＡ。结果：与正常对照比较，慢性乙肝患者ＣＤ＋４细胞数、ＣＤ＋４／ＣＤ＋８比值及ＩＬ－２水平均明显下降，ＣＤ＋８细胞数增多。ＣＤ＋４细胞数与ＩＬ－２水平呈正相关，与抗－ＨＢｅ阳性组比较，ＨＢｅＡｇ阳性组ＣＤ＋８细胞数增多，二者在ＣＤ＋４细胞数及ＩＬ－２水平上无差异。动态观察的ＨＢｅＡｇ阳性患者，经由抗－ＨＢｅ阳转进而ｅ系统阴转者仅部分（２／４）出现ＩＬ－２水平升高、ＡＬＴ下降、ＨＢＶ－ＤＮＡ阴转，８例患者的ＩＬ－２水平与ＡＬＴ水平、ＨＢＶ－ＤＮＡ及临床症状有良好的一致性。结论：由以上结果，提示抗－ＨＢｅ阳性阶段机体细胞免疫并未完全得到改善，ＨＢｅＡｇ阳性组ＣＤ＋８细胞数增多，可能是引起肝细胞不断破坏及ＡＬＴ持续增高的因素之一。动态观察结果提示抗－ＨＢｅ的出现不?

Aim Research the meaning of e system on estimating state of illness in chronic hepatitis B further.Methods we collected 59 patients with chronic hepatitis B,among them,28 cases were HBeAg-positive,19 cases were ant-HBe-positive,HBeAg/anti-HBe negative patients were 12.In addition,there were 9 cases as normal controls.Serum interleukin-2 (IL-2) level were tested by indirect sandwich ELISA method,T cell subsets were tested by APAAP method.At the same time,we observed serum IL-2 level.ALT level and HBV-DNA of 8 cases,who converted system negative from HBeAg-positive.Results Compared to controls,number of CD + 4 cell,CD + 4/CD + 8 ratio and serum IL-2 level in patients with chronic hepatitis B decreased,while number of CD + 8 cell increased.There was positive correlation between IL-2 level and number of CD + 4 cell.There was no significant differente between HBeAg-positive and anti-HBe positive patients in number of CD + 4 cell and IL-2 level, while number of CD + 8