HCV侵染患者外周血单个核细胞后对细胞免疫功能的影响

The influence of PBMC infected by HCV on the function of cellular immunity

目的探讨丙型病毒性肝炎（丙肝）患者外周血单个核细胞（ＰＢＭＣ）ＨＣＶＲＮＡ（＋）后对其细胞免疫功能的影响及其在丙肝发病机制中的作用。方法以ＲＴＰＣＲ法检测１３５例丙肝患者ＰＢＭＣ内ＨＣＶＲＮＡ，同时用生物素—链霉亲和素（ＢＳＡ）系统检测其Ｔ细胞亚群及经ＰＨＡ诱导前后膜白介素２受体（ｍＩＬ２Ｒ）的表达水平。结果丙肝患者与正常对照相比，ＣＤ＋３、ＣＤ＋４及ｍＩＬ２Ｒ表达水平降低，ＣＤ＋８水平增高，差异均有显著性（Ｐ＜００１）。ＰＢＭＣ内ＨＣＶＲＮＡ（＋）组与ＨＣＶＲＮＡ（－）组相比较，前者ＣＤ＋３、ＣＤ＋４百分率降低，ＣＤ＋８百分率增高，ＣＤ＋４／ＣＤ＋８比值下降均大于后者，差异有显著性（Ｐ＜００５）。ＰＨＡ诱导前后ＨＣＶＲＮＡ（＋）者明显低于ＨＣＶＲＮＡ（－）者，ｍＩＬ２Ｒ表达水平亦以患者低于正常对照（Ｐ＜００５）。结论丙肝患者细胞免疫功能低下，病毒侵染ＰＢＭＣ后可加重患者的细胞免疫功能紊乱，抑制ｍＩＬ２Ｒ表达，使病情迁延反复。检测丙肝患者ＰＢＭＣ内ＨＣＶＲＮＡ对揭示丙肝发病机制及其防治均有重要意义。

Objective To study the function of cellular immunity after being infected by HCV in peripheral blood mononuclear cells(PBMC) in patients with hepatitis C and effect on pathogenesis of hepatitis C. Methods HCV RNA was detected by reverse transcription nested polymerase chain reaction(RT PCR) from PBMC in 135 cases of hepatitis C, and the expressive level of T cell subsets and membrane interleukin 2 receptor(mIL 2R) before or after PHA inducement were detected by biotin streptavidin(BSA) system. Results The levels of CD 3, CD 4 and mIR 2R were all lower and CD 8 was higher in patients with hepatitis C than in normal control ( P<0 01 ). It was lower in positive HCV RNA than in non positive HCV RNA in PBMC. The levels of mIL 2R before and after PHA inducement were both significantly lower in patients with hepatitis C than those in normal control( P<0 05 ). It was significantly lower in positive HCV RNA than that in nonpositive HCV RNA. Conclusion The function of cellular immunity was lower obviously in patients with hepatitis C. Infection of HCVin PBMC could cause the disorder of cellular immunity function, and restrained the expression of mIL 2R and made the patients condition deferment or relapse. Detection of HCV RNA in PBMC in patients with hepatitis C could help us explain the pathogenesis of hepatitis C, which showed significance for the prevention and treatment of hepatitis C.