酒精性肝硬化外周血淋巴细胞亚群的检测及临床意义

Clinical Significance of the Level of Peripheral Tlymphocyte Subsets in Patients with Alcoholic Hepatic Fibrosis

目的探讨酒精性肝硬化患者外周血淋巴细胞亚群的变化及其与疾病的关系。方法对我院肝病内科病房诊治的92例酒精性肝硬化患者检测淋巴细胞亚群,分析比较肝功能不同Child-Pugh分级患者淋巴细胞亚群的特点。结果 Child-Pugh A、B、C级的淋巴细胞亚群比较,CD3+、CD4+、CD8+、NK、B细胞绝对数均随着病情分级的加重而下降,其中CD3+、CD8+绝对数Child-Pugh A级与C级比较差异有统计学意义(P=0.020,0.036);CD4+绝对数Child-Pugh A级与B级比较差异有统计学意义(P=0.046),Child-Pugh A级与C级比较差异有统计学意义(P=0.016),Child-Pugh B级与C级比较差异有统计学意义(P=0.024);CD4+百分数Child-Pugh A级与C级比较差异有统计学意义(P=0.018);余组间比较差异无统计学意义(P>0.05)。结论酒精性肝硬化患者存在不同程度的免疫功能紊乱,通过检测外周血淋巴细胞亚群,研究患者免疫功能的变化,对本病的诊治和预后判断具有积极的临床意义。

Objective This article aims to investigate the changes of immunity in patients with alcoholic hepatic fibrosis （AHF） by measuring the absolute counts of lymphocyte subsets in peripheral blood. Methods Peripheral venous blood samples from 91 AHF patients admitted into Beijing Youan Hospital during August 2010 and May 2011 were collected, and Tlymphocyte subsets were assayed by flow cytometry. Different samples were compared by one-way ANOVA test. Results There were signifi- cant differences in the absolute counts of Tlymphocyte subsets in AHF patients in different Child-Pugh groups. In severe cases, the absolute counts of CD3 ＋ , CD4 ＋ , CD8 ＋ , NK and B lymphocyte subsets decreased. The absolute counts of CD3 ＋/CD8 ＋ Tlymphocyte subset in in Child-Pugh C group was lower than that in Child-Pugh A group （P = 0. 020, 0. 036）. The absolute counts of CD4 ＋ Tlymphocyte subset in Child-Pugh B group was lower than that in Child-Pugh A group （P = 0. 046） , the abso- lute count CD4 ＋ Tlymphocyte subset in Child-Pugh C group was lower than that in Child-Pugh A group （P = 0. 016） , and the absolute counts of CD4 ＋ T lymphocyte subset in Child-Pugh B group was lower than that in Child-Pugh C group （P = 0. 024）. There was statistical significance on CD4 ＋ percentage, class A and class B （P = 0. 018）. There was no statistical significance among other subsets, unless otherwise indicated. Conclusion The patients with alcoholic hepatic fibrosis tend to suffer from immune functional disorder.