脾切除对乙型肝炎肝硬化患者外周血T细胞及其活化抗原HLA-DR的影响

Study on the expression of activated antigen HLA-DR in peripheral blood T lymphocyte subsets of patients with cirrhosis after splenectomy

目的:检测乙型肝炎肝硬化脾切除患者外周血T细胞活化抗原HLA-DR的表达水平,探讨其临床意义。方法:以28例乙型肝炎肝硬化脾切除患者为实验组(肝硬化脾切除组),同时以38例乙型肝炎肝硬化非脾切除患者和22例健康人为对照组(肝硬化非脾切除组、健康组)。采用流式细胞技术检测外周血T淋巴细胞亚群及HLA-DR抗原的表达。结果:肝硬化脾切除组患者外周血CD3+、CD4+和CD8+百分含量分别为(41.59±6.79)%,(22.64±6.87)%和(19.16±7.28)%,显著低于健康组和肝硬化非脾切除组。肝硬化脾切除组患者CD4+/CD8+的比值显著高于健康组;HLA-DR在CD3+、CD4+和CD8+上的表达水平分别为(25.42±5.51)%,(22.36±4.90)%和(28.53±8.35)%,与健康组相比差异无统计学意义,但在CD3+和CD8+上的表达水平显著低于肝硬化非脾切除组。结论:肝硬化脾切除患者存在细胞免疫功能缺陷,表现为T细胞数量的减少和活化功能的下降。

Objective： To explore clinical significance by detecting the expression of HLA-DR antigen in peripheral blood T lymphocyte subsets of patients with cirrhosis after splenectomy. Methods： Twenty eight patients with cirrhosis received splenectomy were enrolled in the study, meanwhile, thirty eight patients with cirrhosis without splenectomy and twenty-two health donors were followed-up as the controls. The expressions of HLA-DR antigen in peripheral blood T lymphocyte subsets were detected by flow cytometry. Results： The levels of CD3＋, CD4＋ and CD8＋ were（41.59±6.79）% ,（22.64±6.87）% and（19.16±7.28）% respectively in peripheral blood of patients with splenectomy, which were significantly lower than that of the controls. The ratio of CD4＋/CD8＋ was higher than that of the health control. The expressions of HLA-DR on CD3＋, CD4＋ and CD8＋ were （25.42±5.51）% , （22.36±4.90）% and （28.53±8.35）% respectively in peripheral blood of patients with splenectomy. The expression of HLA-DR on CD4＋ and CD8＋ in patients with splenectomy was significantly higher than that of patients without splenectomy. Conclusion： There is cellular immune deficiency in patients with splenectomy. The expression of CD3＋, CD4＋ and CD8＋ decrease significantly, and the levels of activated antigen HLA-DR on T cell subsets are low.