肝炎患者T淋巴细胞PD-1/B7-H1通路表达的变化及其临床意义

Change of PD-1/B7-H1 pathway expression and its clinical significance of T lymphocytes in hepatitis patients

目的探讨重型肝炎(SH)患者T淋巴细胞程序性死亡因子-1(PD-1)以及其配体B7-H1的表达以及对患者预后的影响。方法选择该院30例SH患者,30例慢性乙型肝炎,另选取30例健康患者作为对照。分别检测3组T淋巴细胞PD-1/B7-H1的表达水平以及T细胞亚群计数,同时对生存以及死亡重型肝炎患者的PD-1/B7-H1进行分析。结果重型肝炎患者T淋巴细胞PD-1、B7-H1的阳性表达率为[(5.32±0.64)%、(7.65±0.82)%];慢性乙型肝炎阳性表达率为[(9.98±1.63)%、(15.97±2.48)%)];与健康组[(1.69±0.31)%、(1.83±0.28)%]比较,差异具有统计学意义(均P<0.05);重型肝炎患者的CD4+、CD8+细胞数分别是(43.0±9.2)%、(11.0±4.8)%与健康组[(55.0±9.7)%、(24.5±7.9)%]比较,差异具有统计学意义(P<0.05);死亡重型肝炎患者的PD-1/B7-H1为(6.32±0.95)%和(9.15±1.02)%,生存患者为(3.79±0.63)%和(5.82±0.67)%,差异有统计学意义(P<0.05)。结论重型肝炎患者的T淋巴细胞PD-1/B7-H1表达水平明显的提高,跟患者的预后情况具有密切的相关性。

Objective To investigate the expressions of programmed cell death factor-1（PD-1） of T lymphocytes and its ligand B7-H1 in the patients with severe hepatitis（SH） and their influence on prognosis.Methods 30 patients with SH,30 patients with chronic hepatitis B and other 30 healthy individuals as control were selected from this hospital.The expression of PD-1/B7-H1 and T cell subsets counts in 3 groups,and PD-1/B7-H1 in survival and death patients with SH were analyzed.Results The PD-1 and B7-H1 positive expression rates in SH patients were（5.32±0.64）% and（7.65±0.82）%,which in the chronic hepatitis B patients were（9.98±1.63）% and（15.97±2.48）%,which in the healthy group were（1.69±0.31）% and（1.83±0.28）%,respectively,difference was statistically significant（all P0.05）.CD4＋ and CD8＋ cell counts were（43.0±9.2）% and（11.0±4.8）% in SH patients and（55.0±9.7）% and（24.5±7.9）% in the healthy group,respectively,the difference was statistically significant（P0.05）.PD-1 and B7-H1 expression was（6.32±0.95）% and（9.15±1.02）% in SH death patients and（3.79±0.63）% and（5.82±0.67）% in SH survival patients,the difference was statistically significant（P0.05）.Conclusion PD-1/B7-H1 expression levels of T lymphocytes in SH patients are increased significantly and closely correlated with the prognosis of patient.