摘要
目的探讨慢性乙型肝炎(CHB)患者丙氨酸转氨酶(ALT)水平与乙型肝炎病毒(HBV)特异性细胞毒性T淋巴细胞(CTL)、非特异性CTL的关系。方法148例CHB患者根据ALT水平分为3组:甲组35例,ALT≥2×正常值上限(ULN)~5×ULN(100~250IU/L);乙组53例,ALT〉5×ULN~≤10×uLN(251~500IU/L);丙组60例,A岍〉10×ULN(〉500IU/L),用流式细胞仪检测非特异性CTL,对其中74例(甲组17例,乙组27例,丙组30例)人白细胞抗原(HLA)-A2阳性CHB患者检测HBV特异性CTL。比较三组的HBV特异性CTL、非特异性CTL、HBVDNA水平和HBeAg阳性率。结果HBV特异性CTL:甲组[(0.42±0.10)%]高于乙组[(0.25±0.08)%],t=6.37,P〈0.01,乙组高于丙组[(0.17±0.004)%]t=5.14,P〈0.01。非特异性CTL:甲组[(15.01±3.01)%]低于乙组[(18.1±5.02)%],t=2.81,P〈0.01,乙组低于丙组[(21.5±6.11)%]t=3.07,P〈0.01。HBVDNA水平:甲组[(4.97±0.86)log^10拷贝/ml]低于乙组[(5.92±0.92)log^10拷贝/ml],t=4.87,P〈0.01,乙组低于丙组[(6.37±0.71)log^10拷贝/ml]t=2.92,P〈0.01。HBeAg阳性:甲组15例(42.86%),低于乙组(32例,占60.38%),χ^2=2.59,P〉0.05,乙组低于丙组(41例,占68.33%),χ^2=0.788,P〉0.05,甲组低于丙组χ^2=5.929,P〈0.05。结论CHB患者非特异性CTL越高,AIJT水平越高^[1],而HBV特异性CTL越低,HBV复制越强。
Objective To explore relations between ALT level and hepatitis B virus (HBV) specific CTL and non-specific CTL in patients with chronic hepatitis B (CHB). Methods 148 cases of CHB were divided into three groups according to ALT level. 35 cases in group A, ALT≥2 × upper limit of normal value (ULN)--5 × ULN (100--250 IU/L) ; 53 cases in group B, ALT 〉 5 × ULN--≤ 10 × ULN (251--500 IU/L) ; 60 cases in group C, ALT 〉 10 × ULN( 〉 500 IU/L) . Flow cytometry is used to determine non-specific CTV. HBV specific CTL was tested on 74 cases of CHB (17 in group A, 27 in group B and 30 in group C) with positive (HLA)-A2. Compare HBV specific CTL, non-specific CTL, HBV DNA levels and positive rate of HBeAg. Results HBV specific CTL: Group A (0.42 ±0. 10) % is higher than group B (0.25 ± 0.08) %, t = 6.37, P 〈 0.01, group B is higher than group C (0.17 ± 0.004)%, t = 5.14, P 〈 0.01; Non-specific CTL: Group A (15.01 ± 3.01)% is lower than group B (18.1 ±5.02)%, t =2.81, P 〈0.01, group B is lower than group C (21.5 ± 6.11)%, t = 3.07, P 〈 0.01 ; HBV DNA level : Group A [ (4.97 ± 0.86) log^10 copies/ml] is lower than group B [ (5.92 ± 0.92) log^10 copies/ml], t = 4.87, P 〈 0.01. Group B is lower than group C [ (6.37 ± 0.71) log^10 copies/rnl], t = 2.92, P 〈 0.01 ; Positive HBeAg: Group A (15 cases, 42.86% ) is lower than group B (32 cases, 60.38% ), 2 = 2.59, P〉0.05. Group B is lower than group C (41 cases, 68.33%), χ^2 = 0.78, P 〉 0.05. Group A is lower than group C, χ^2 = 5.929, P 〈 0.05. Conclusion The higher the non-specific CTL of patients with CHB is, the higher the ALT level would be, whereas the lower the HBV specific CTL is, the stronger the HBV replication would be.
出处
《中华实验和临床病毒学杂志》
CAS
CSCD
北大核心
2009年第5期343-345,共3页
Chinese Journal of Experimental and Clinical Virology