肝炎肝硬化患者外周血树突状细胞亚群的鉴定及其临床意义

Identification and significance of peripheral blood dendritic subsets in liver cirrhotic patients with chronic HBV infection

为建立流式细胞术检测肝炎肝硬化患者外周血树突状细胞(DC)亚群的方法,初步探讨其临床价值。本文采用三色流式细胞分析技术对37例肝炎肝硬化患者、24例慢性乙肝患者和10例健康人(对照组)外周血中DC细胞亚群进行检测,同时也检测了淋巴细胞亚群的变化,并对患者DC亚群和淋巴细胞亚群的变化进行了分析比较,来了解这些变化与疾病发展的关系。结果表明,采用不同的流式抗体组合在流式细胞双参数点图上可以清晰地分离出DC不同亚群细胞群,即DC1和DC2。同时发现与健康对照组相比,肝炎肝硬化患者和慢性乙肝患者外周血DC1和DC2百分数明显降低(P<0.05);DC2细胞的绝对数在肝炎肝硬化患者中降低更加明显(P<0.05);同时T淋巴细胞亚群检测发现CD8+T数在慢性乙肝和肝炎肝硬化患者中明显低于正常对照组,肝炎肝硬化组CD4+T、CD8+T数显著低于慢性乙肝组。综上所述,用流式细胞技术来鉴定和分离DC亚群是一种简便有效的方法。肝炎肝硬化患者外周血DC1和DC2数量减少,特别是DC2细胞绝对数明显降低,同时伴随有CD8+T细胞数的降低,提示这些抗病毒免疫活性细胞的减少,可能是导致肝炎肝硬化形成的原因之一。

To establish a flow cytometric method for detecting peripheral blood dendritic cell（DC） subsets in liver cirrhotic pa- tients with chronic HBV infection and evaluate their clinical significance, flow cytometry was used to analyze the peripheral blood dendritic cell subsets and T lymphocyte subsets from 37 cases of liver cirrhotic patients with HBV infection ,24 cases of chronic HBV infected patients and 10 healthy blood donors. The clinical significance was evaluated according to the changes of DC subsets and T lymphocyte subsets. The results showed that the three-color antibody combinations could effectively identify the 2 DC subsets, i.e. DC1 and DC2. Compared with the healthy subjects, both patient groups had a significantly decreased number of DC1 and DC2 subsets as well as CD8＋ T lymphocytes（P^0.05）. The absolute number of DC2 in liver cirrhotic pa- tients with chronic HBV-infection was significantly lower than that in the chronic HBV- infected patients and healthy controls （P%0.05）. However ,there was no significant difference in DC1 and CD4＋ T cells between the two patient groups. In summary , flow cytometry is a simple method for analyzing DC subsets. The proportion of DC1 and DC2 ,and the absolute number of DC2 and CD8＋ T cells in the peripheral blood of liver cirrhotic patients with chronic hepatitis B was decreased significantly, resulting in the development of liver cirrhosis in patients with chronic hepatitis B.