慢性乙型肝炎病毒感染者辅助性T淋巴细胞亚群的变化

Variance of helper lymphocyte T cell subsets in patients with chronic hepatitis B virus infection

目的了解慢性乙型肝炎病毒(HBV)感染者体内辅助性T淋巴细胞(Th细胞)亚群的变化,探讨HBV感染慢性化与Th细胞亚群变化的关系。方法通过细胞内染色技术,采用流式细胞术检测HBV感染者外周血中Th1细胞和Th2细胞的水平。结果慢性HBV感染者中,乙型肝炎病毒e抗原(HBeAg)阳性感染组和HBV-DNA复制组Th1数量明显低于健康对照组(9.46±2.06,9.52±2.41与11.18±3.12相比,P<0.05);HBeAg阳性组、丙氨酸氨基转移酶(ALT)升高组、HBV-DNA复制组Th2细胞数量明显高于健康对照组(3.05±1.12,3.12±1.12,2.97±1.12与2.38±0.96相比,P<0.05);HBeAg阳性感染组、ALT升高组和HBV-DNA复制组Th1/Th2比值都明显低于健康对照组差异有统计学意义(P<0.05)。结论慢性HBV感染者Th1/Th2比例失衡,表现为Th1/Th2比值下降,Th2细胞数量优势,Th1/Th2比例失衡可能与肝脏损伤程度和病毒复制水平有关,Th1/Th2比值可以作为监测HBV慢性感染者免疫状态的重要指标。

Objective To investigate the variance of helper lymphocyte T cell subsets in patients with chronic hepatitis B virus （HBV） infection, and to explore the relationship of chronicity of HBV infection and variance of helper lymphocyte T cell subsets. Methods Intracellular staining technique and flow cytometry were employed to measure peripheral blood levels of Th1 and Th2 cells. Results The percentages of Th1 cells in HBeAg（＋） group and HBV-DNA replicating group were significantly lower than that of control group （9.42±2.03,9.52 ±2. 41 vs 11.18±3.12,P〈0.05）. The percentages of Th2 cells in HBeAg （＋） group, ALT increasing group, HBV-DNA replicating group were significantly higher than that of control group （3.05±1.12, 3. 12±1. 12, 2.97±1. 12 vs 2.38±0.96,P〈0.05）. All the Th1/Th2 ratios in HBeAg（＋） group, ALT increasing group and HBV-DNA replicating group were significantly lower than that of control group （P〈0.05）. Conelusion There exists Th1 Th2 ratio imbalance in chronic HBV infection, displaying Th1/Th2 ratio decreases and Th2 cell prevails. The imbalance of Th1/Th2 ratio may be associated with degree of hepatic injury and viral replication. Th1/Th2 ratio can be used as an important index to monitor the immune state in patients with HBV infection.