慢性乙型肝炎患者外周血TNF–α及T细胞亚群与肝血管病变关系

The relationship of peripheral blood T cell subsets,serum of tumor necrosis factor α and intrahepatic vascular lesion in patients with chronic hepatitis B

目的:研究慢性乙型肝炎患者外周血肿瘤坏死因子α及T细胞亚群的变化与肝血管病变关系。方法:90例乙型肝炎患者及10例对照性肝组织病理学检查,并依据血管病变程度将其分为4组。采用酶联免疫吸附法(ELISA)定量检测TNF-α含量。用流式细胞术检测外周血T细胞亚群。结果:①各级乙型肝炎肝血管病变病人血清TNF-a水平均明显高于对照组(P<0.01),TNF-a水平与肝炎病人的肝血管病变程度呈正相关(rs=0.773,P<0.05)。②各级乙型肝炎肝血管病变病人外周血CD8+T细胞的水平均明显高于对照组(P<0.05),CD4+/CD8+T细胞的比值明显低于对照组(P<0.05),不同级别肝血管病变患者之间比较无统计学意义(P>0.05)。结论:肿瘤坏死因子α及细胞免疫在肝血管病变的发生及发展过程可能起着重要的作用。

Objective：To study the relationship of intrahepatic vascular lesion,serum of tumor necrosis factor-α（TNF-α）and peripheral blood T cell subsets in patients with chronic hepatitis B.Methods： Histopathological examinations were performed in ninety patients with chronic hepatitis B and ten controls.These patients were divided into four groups according to intrahepatic vascular lesion classification.The serum levels of TNF–α were determined by ELISA,and peripheral blood T cell subsets were analyzed by flow cytometry.Results： ① Serum of TNF-α in the groups with intrahepatic vascular lesion were significantly higher than that of the controls（P〈0.01）,significant positive correlation lied between the intrahepatic vascular lesion classification and serum of TNF-α（rs=0.773,P〈0.05）.② The level of CD8^＋ in the groups with intrahepatic vascular lesion were significantly higher than that of the controls（P〈0.05）,and the ratio of CD4^＋/CD8^＋ in the groups with intrahepatic vascular lesion were significantly lower than that of the controls（P〈0.05）,but the level of CD8＋ cells and the ratio of CD4＋/CD8＋ showed no significance among the groups with intrahepatic vascular lesion Ⅰ–Ⅲ grade.Conclusion： TNF-α and disorder of cellular immunity may play an important role in the development and progression of intrahepatic vascular lesion.