重型乙型肝炎前期患者外周血免疫活性细胞的特点

The characteristics of immunocompetent cells in peripheral blood on prophase of severe hepatitis B

目的分析重型乙型肝炎前期（以下简称重肝前期）患者外周血免疫活性细胞的特点。方法选取重肝前期患者48例，慢性乙型肝炎患者35例，健康志愿者20例，采用流式细胞仪检测外周血淋巴细胞CD3＋、CD3＋／CD4＋、CD3＋／CD8＋、CD4＋／CD25＋／CD45＋等亚群表达百分比，计算各淋巴细胞亚群绝对值，并进行统计学分析。结果与慢性乙肝组及健康对照组相比，重肝前期组CD3＋T细胞、CD8＋T细胞、CD4＋CD25＋调节性T细胞（Tregs）的绝对值均明显下降（P〈0．01或P〈0．05）；重肝前期组CD4＋T细胞绝对值与慢性乙肝组差异无统计学意义（P〉0．05），但CD4＋T细胞百分率明显高于慢性乙肝组（P〈0．05）。此外，CD4＋／CD8＋比值各组间存在显著差异，重肝前期组显著高于慢性乙肝组和健康对照组（P〈0．01或P〈0．05）。结论重型乙型肝炎前期存在一定程度的细胞免疫功能紊乱，其特征为CD4＋T细胞占优势，CD8＋T细胞和CD4＋CD25＋Tregs绝对值下降。

Objective To anatyze the characteristics of immunocompetent cells in peripheral blood on prophase of severe hepatitis B （PSHB）. Methods 48 cases of PSHB patients, 35 cases of chronic hepatitis B（CHB） patients and 20 cases of healthy volunteers were enrolled for detection of CD3＋ , CD3＋/ CD4 ＋ , CD3 ＋/C＇D8 ＋ and CD4 ＋/CD25 ＋/CD45 ＋ lymphocyte subsets in peripheral blood by flow eytometry. The absolute numbers of each lymphocyte subset were calculated and analyzed statistically. Results Compared with CHB group and healthy control group, The absolute numbers of circulating CD3＋, CDS＋T cells and CD4 ＋ CD25 ＋ regulatory T cells （Tregs） were significantly lower in PSHB group（P 〈 0. 01 or P 〈 0. 05）. There was no significant difference on the absolute numbers of circulating CD4 ＋ T cells between PSHB group and CHB group （P 〉 0.05） ,while the percentage of lymphocyte subsets CD4 ＋ in PSHB group was significantly higher than that in CHB group （P 〈 0. 05）. In addition, CD4 ＋/CD8 ＋ ratio in PSHB were significantly higher than those in the CHB group and heahhy control group （ P 〈 0.01 or P 〈 0.05 ）. Conclusion .PSHB has a certain degree of cellular immune dysfunction, which characterized by CD4 ＋T cells dominated and the decline of absolute numbers of CD8 ＋ T ceils and CD4 ＋ CD25 ＋ Tregs.