慢性HBV感染者外周血T细胞亚群研究

Study on function of T-lymphocyte subsets in peripheral blood of patients with chronic hepatitis B

目的分析健康人及慢性HBV感染者T细胞亚群特点,探讨宿主细胞免疫功能与慢性HBV感染临床转归的关系。方法使用流式细胞仪检测30名健康人及137例各型HBV感染者外周血T细胞亚群。结果 1.对照组与各型HBV感染者的外周血T细胞亚群比较:从慢性HBV携带(CHBVC)组、慢性乙型肝炎(CHB)组到肝炎后肝硬化(PHBC)组,患者外周血CD3+T、CD4+T和CD8+T绝对值呈逐渐下降趋势,显著低于对照组(P<0.05)。PHBC组CD4+T/CD8+T比值显著高于对照组和CHBVC组(P<0.05)。2.不同程度CHB组间外周血T细胞亚群比较:从CHB(轻度)组、CHB(重度)组到慢性重型乙型肝炎(CSHB)组,患者CD3+T、CD4+T、CD8+T绝对值和CD4+T/CD8+T比值逐渐下降。CSHB组CD3+T、CD4+T和CD8+T绝对值显著低于CHB(轻度)组(P<0.05)。结论 HBV慢性感染机制复杂,不同的临床转归患者T细胞亚群状态不同。慢性HBV感染后,肝脏损害程度严重的患者T细胞亚群功能低下及紊乱程度明显。

Aim To analyse the function of T-lymphocyte subsets in healthy people and patients with chronic hepatitis B （CHB） and explore the correlation between the host cell immune function and clinical outcomes of chronic HBV infection. Methods T-lymphocyte subsets of 30 healthy people and 137 patients with CHB were detected by flow cytometry（FCM）. Results The patients in CHBVC （chronic HBV and HBSAg carriers）group,CHB group and PHBC （posthepatitie B cirrhosis）group,peripheral blood T lymphocyte counts showed a gradual declining trend （including CD3^＋T,CD4^＋T,CD8^＋T） and showed statistically significant difference as compared with the control group （P〈0.05）. The ratio of CD4^＋T/CD8^＋T in PHBC group was significantly higher that the control group and the CHBVC group（P〈0.05）. The levels of CD3^＋T,CD4^＋T and CD8^＋T and the ratio of CD4^＋T/CD8^＋T in CHB（mild）group,CHB（severe）group and CSHB（chronic severe hepatitis B）group were decreased gradually,the levels of CD3^＋T,CD4^＋T and CD8^＋T in CSHB group was significantly lower than CHB （mild）group（P〈 0.05）： Conclusion Pathogenesis of chronic HBV infection in the body is complex. It was the result of the interaction between tile HBV and immune system .Different prognosis of HBV-infection varies with different function of T-lymphocyte subsets. The immune function of T-lymphocyte subsets in patients with severe hepatic lesions is lower an out of order.