慢性丙型肝炎患者外周血淋巴细胞亚群与病毒载量的相关性分析

Study on the Relationship Between the Peripheral T Cell Subsets Distribution Type and Virus Load in Patients with Chronic Hepatitis C

目的:分析慢性丙型肝炎患者外周血淋巴细胞亚群的变化以及与HCV病毒载量的相关性,探讨慢性HCV感染慢性化的免疫机理。方法:应用直接免疫荧光-流式细胞术检测47例慢性丙型肝炎患者外周血T淋巴细胞亚群及NK细胞的相对数量,与35例正常健康人做比较;应用实时荧光定量RT-PCR对其外周血HCV病毒载量进行检测,将慢性HCV感染者分为两组进行比较分析。结果:外周血CD4+T淋巴细胞比例和CD4/CD8比值慢性丙型肝炎患者组低于正常人组(P<0.05),HCV RNA阳性组与HCV RNA阴性组之间的差异无统计学意义(P>0.05);NK细胞比例慢性丙型肝炎患者组高于正常人组(P<0.05),HCV RNA阴性组高于HCV RNA阳性组(P<0.05)。结论:慢性HCV感染者存在细胞免疫功能低下,NK细胞介导非特异性免疫的持续上调,在有效地清除了部分HCV病毒的同时,可能促进了持续性免疫性肝损伤。

Objective To study the immtmo - mechanism of HCV persistent infection in patients with chronic hepatitis C with determination of the peripheral T - cell subsets distribution type and v/ms load. Methods Peripheral T - cell subsets distribution type and NK cell was examined with mono - clonal antibody technique and flow - cytometry and quantity of virus was examined with RT - PCR in 47 patients with chronic hepatitis C and 35 controls. Results Among the 47 patients, 25 were HCV - RNA positive （ over 103 copies/ml） and 22 were HCV - RNA negative. The CD3 CD4%, CD3 CD8% and CD4/CD8 ratio were significantly lower in the patients than those in controls （ P 〈 0.05） with no significant difference between those in HCV - RNA positive and negative patients （ P 〉 0.05）. Conversely, the NK cell （CD56） % was significantly higher in the patients （ P 〈 0.05） and among the patients, significantly higher in the HCV - RNA positive ones （ P 〈 0.05 ）. Conclusion There was impairment of acquired cellular immunity function in patients with chronic hepatitis C. The innate immunity mediated by NK cell was up - regulated with partial clearance of HCV but accompanied with persistent hepatic cell injury from immuno-reaction.