慢性乙型肝炎病毒感染者外周血T细胞亚群变化与其血清HBV DNA的水平分析

Relation of Peripherol T-cell Subsets Variation and HBV-DNA Levels in Chronic Hepatitis B-Virus Infectied Subjects

目的观察慢性乙肝病毒(HBV)感染者细胞免疫功能的变化,探讨病毒复制程度与细胞免疫功能的关系。方法应用流式细胞仪直接免疫荧光法检测230例乙肝病毒感染者5、0例正常对照外周血T细胞亚群百分率,用荧光定量PCR法检测乙肝感染者血清HBV DNA。结果HBV感染者外周血CD4+T细胞百分率及CD4+/CD8+比值较正常对照组明显减低(36.8±10.6%vs 39.4±9.8%,P<0.05;1.5±0.8 vs 1.9±0.9,P<0.01),CD8+T细胞百分率明显升高(27.9±8.3%vs 24.1±7.0%,P<0.01),而CD3+T细胞百分率无明显差异(70.2±10.3%vs 69.9±5.2%,P>0.05)。根据HBV感染者血清中HVB DVA载量的高低,将它们分为低拷贝组(103-104copies/ml),高拷贝组(105-108copies/ml)以及DNA阴性组(<102copies/ml)。低拷贝组和高拷贝组的CD4+T细胞百分率及CD4+/CD8+比值比对照组明显减低(36.4±10.9%vs 39.4±9.8%,P<0.05;36.4±10.9%vs 39.4±9.8P<0.05;1.5±0.9 vs 1.9±0.9,P<0.01;1.1±0.7 vs 1.9±0.9,P<0.01),高拷贝组的CD4+/CD8+比值比低拷贝组和DNA阴性组明显减低(1.1±0.7 vs 1.5±0.9,P<0.01;1.1±0.7 vs 1.6±0.8,P<0.01),CD8+细胞百分率明显高于对照组和DNA阴性组(29.4±8.4%vs 24.1±7.0%,P<0.01;29.4±8.4%vs 25.7±7.3%vs 24.1±7.0%P<0.05)。而CD3+T细胞百分率在各组之间没有明显差异存在(P>0.05),CD4+在低、高拷贝组及DNA阴性组之间虽无明显差异存在(P>0.05),但随着DNA复制的增加,CD4+呈逐渐减少趋势。结论HBV感染可导致感染者细胞免疫功能的改变,HBA DNA复制增加进一步加重乙肝病毒感染者T细胞亚群的率乱,CD4+/CD8+比值的动态变化可及时提示临床HBV感染者细胞免疫功能的变化并加强临床的临测。

Objective To investigate the significance relation of serum hepatitis B virus （HBV） DNA levels and cellular immmunity in chronic hepatitis B virus infection.Methods Peripheral T-cell subsets were determined in 230 HBV infected subjects and 50 health controls by direct immunofluoresscence using flow cytometry, HBV DNA were determied by fluoresscence quantity PCR. Results The rate of CD4^＋ cells and the ratio of CD4^＋/CD8^＋ were significantly reduced in chronic HBV infections as compared with health controls （36.8 ± 10.6% vs 39.4 ± 9.8%, P 〈 0.05; 1.5 ± 0.8 vs 1.9 ± 0.9, P 〈 0.01） ,and the rate of CD8^＋ cells were significantly increased （27.9 ± 9.3% vs 24.1 ± 7.0%, P 〈 0.01） ,But the rate of CD3^＋ cells in HBV infections showed no significant difference from health controls （ P 〉 0.05） o According to the level of HBV DNA in patients＇ serum, we divided them to three groups：the group of DNA low copies （ 10^3 - 10^4 copies/ml） ,group of DNA high copies （ 10^5 - 10^8 copies/ml） and group of DNA negfive （ 〈 10^2 coples/ml）. The rate of CD4^＋ cells and the ratio of CD4^＋/CD8^＋ were also significantly decreased in group of DNA low and high copies as compared with health controls （36.4 ± 10.9% vs 39.4 ± 9.8%, P 〈 0.05;36.4 ± 10.9% vs 39.4 ± 9.8 P 〈 0.05; 1.5±0.9 vs 1.9±0.9, P〈0.01;1.1 ±0.7 vs 1.9±0.9, P〈0.01）.The ratio of CD4^＋/CD8^＋ in group of DNA high copies were marldy drecreased. The rate of CD3^＋ cells showed no sighifieanfly difference in each group. There was no significantly difference as compared with HBV levels, but the rate of CD4^＋ was lower with increasing levels of HBV DNA. Conclusion Chronic HBV infection can lead to disorder of cellular immunity, and disorder can be promoted by the increased serum levels of BHV DNA. The dynamic changes of CD4^＋/CD8^＋ can indicate the changeable cellular immune functions of HBV infections and improve the clinical inspections.