慢性乙型肝炎患者CD_4^+CD_(25)^+调节性T细胞及部分细胞因子的变化

The research of CD_4^+CD_(25)^+Treg and partial cytokines from patients with chronic hepatitis B

目的研究慢性乙型肝炎(CHB)患者外周血CD4+CD25+调节性T细胞和血清IL-2、IL-4、IL-10、IFN-γ和TGF-β的变化,探讨其与乙型肝炎慢性化的关系。方法选择24例CHB患者作为CHB组、8例急性乙型肝炎(AHB)患者作为AHB组,12例健康体检者作为正常对照组,流式细胞仪检测各组CD4+CD25+调节性T细胞的百分率,ELISA双抗体夹心法检测慢性乙型肝炎组和正常对照组上述5种细胞因子的水平。结果 CHB组CD4+CD25+调节性T细胞百分率均明显高于AHB组和正常对照组,差异有统计学意义(P<0.01)。CHB组和AHB组的CD4+CD25+Treg百分率与血清HBV-DNA及ALT之间无相关关系(P>0.05)。CHB组血清IL-2、IL-4、IL-10、IFN-γ和TGF-β水平均高于正常对照组,差异有统计学意义(P<0.01)。CHB组IL-2及IFN-γ分别与ALT正相关(P<0.05)。结论慢性乙型肝炎患者存在免疫紊乱,CD4+CD25+调节性T细胞和Th1/Th2细胞的失衡与乙型肝炎慢性化有关。

Objective To explore the percentages of CD4＋CD25＋Treg in peripheral blood from patients with chronic hepatitis B（CHB） and detect the levels of IL-2,IL-4,IL-10,IFN-γ and TGF-β in serum and investigate the roles of CD4＋CD25＋Treg and cytokines in blood on the chronicity of hepatitis B.Methods Selecting 24 cases of CHB as CHB group,8 cases of acute hepatitis B（AHB） as AHB group and 12 healthy persons as the normal control group.Detect the percentage of CD4＋CD25＋Treg in peripheral blood of the three groups with flow cytomerty and detect the levels of the five cytokines above in CHB group and the normal control group with double antibody sandwich method of ELISA.Results The percentages of CD4＋CD25＋Treg in CHB group is obviously higher than that of AHB group and that of the normal control group（both P0.01）.There is no correlation between CD4＋CD25＋Treg and HBV-DNA or ALT both in the groups of CHB and AHB（P0.05）.The levels of IL-2,IL-4,IL-10,IFN-γ and TGF-β in CHB group are higher than that of the normal control group（P0.01）.There is a positive correlation between ALT and IL-2 or IFN-γ in CHB group,respectively（P0.05）.Conclusion There exists immunologic derangement in patients with chronic hepatitis B.CD4＋CD25＋Treg and Th1/Th2 imbalance play an active role in the chronicity of hepatitis B.