慢性乙型肝炎肝硬化淋巴细胞亚群及HLA-DR抗原的表达

Expression of lymphocyte populations and HLA-DR antigen in patients with chronic hepatitis B and cirrhosis

目的检测慢性乙型肝炎和肝硬化患者外周血淋巴细胞亚群和T细胞活化抗原HLA-DR的表达,探讨其免疫功能变化及临床意义。方法研究对象为慢性乙型肝炎和肝硬化患者,共127例,其中慢性乙型肝炎61例(轻度17例,中度25例,重度19例),肝硬化66例(脾切除28例,非脾切除38例),同时设立健康对照组22例。采用流式细胞术检测患者外周血淋巴细胞亚群和T细胞活化抗原HLA-DR。结果慢性重度乙型肝炎患者CD_8^+细胞高于健康对照组,慢性轻度和中度乙型肝炎CD_8^+细胞与健康对照组无差异;肝硬化脾切除及非脾切除患者CD_3^+和CD_8^+细胞低于健康对照组,肝硬化脾切除患者同时有CD_4^+细胞下降。肝硬化脾切除患者CD3+、CD_4^+和CD_8^+细胞低于非脾切除组;肝硬化脾切除及非脾切除患者CD_(19)^+高于健康对照组;肝硬化脾切除组HLA-DR抗原与健康对照组无差异,其余各组均高于健康对照组。肝硬化脾切除患者CD_3^+ DR^+和CD_8^+ DR^+抗原低于肝硬化非脾切除组。结论慢性乙型肝炎和肝硬化患者存在一定的免疫功能紊乱现象,主要表现为T细胞数量失衡和活化异常,以肝硬化脾切除患者最为明显。

【Objective】 To observe change of immune function and clinical significance by detecting the expression of lymphocyte populations and HLA-DR antigen of patients with chronic hepatitis B and liver cirrhosis. 【Methods】Enrolled 127 patients with chronic hepatitis B and cirrhosis in the study were divided into 5 groups： chronic slight hepatitis B （17 cases）, chronic mild hepatitis B （25 cases）, chronic serious hepatitis B （19 cases）, cirrhosis without splenectomy （38 cases） and cirrhosis with splenectomy （28 cases）. Meanwhile, twenty-two healthy donors were established as the control. The expressions of lymphocyte population and HLA-DR antigen in peripheral blood were detected by flow cytometry. 【Results】The level of CD8＋ in patients with chronic serious hepatitis B was increased, in which patients with chronic slight and mild hepatitis B were no different from that of the health group. The expressions of CD3^＋, CD8^＋ in patients with liver either splenectomy or without splenectomy were decreased significantly than that of the health control, meanwhile the expression of CD4^＋ in patients with cirrhosis with splenectomy was decreased; The expressions of CD3^＋, CD4^＋, CD8^＋ of patients with splenectomy were significantly decreased than that of cirrhosis without splenectomy. The level of CD19^＋ of patients with cirrhosis was increased than that of the health group. Excepted patients with splenectomy, the expression of HLA-DR antigen in T cell of patients with chronic hepatitis B and cirrhosis without splenectomy were significantly increased than that of the health group. The levels of CD3^＋ DR^＋, CD4^＋ DR^＋, CD8^＋ DR^＋ in patients with splenectomy were increased than that of cirrhosis withoutsplenectomy. 【Conclusion】Immunity function of patients with chronic hepatitis B and cirrhosis are imbalance, one hand, the expression of T cell is imbalance, on the other hand activity of T cell is disbalance, which is obvious for patients in cirrhosis with splenectomy.