慢性丙型肝炎患者治疗前后外周血T细胞CD28、CD152水平变化分析

Changes of CD28,CD152 on surface of peripheral blood T cells after treatment in patients with chronic hepatitis C

目的观察慢性丙型肝炎患者治疗前后外周血T细胞CD28、CD152水平变化,为慢性丙肝临床治疗提供依据。方法选择40例慢性丙型肝炎患者作为观察组,40例健康人作为对照组,利用流式细胞仪测定用荧光抗体CD4-PECY5、CD8-PE标记过的患者CD4+淋巴细胞和CD8+淋巴细胞表面CD28、CD152表达水平,分析其治疗前后变化水平。结果观察组慢性丙型肝炎患者治疗前CD4+CD28、CD8+CD28明显低于对照组(P<0.05);观察组患者经过治疗后CD4+CD28、CD8+CD28明显升高(P<0.05);治疗后观察组患者CD4+CD28、CD8+CD28与对照组相比较无明显差异(P>0.05);观察组慢性丙型肝炎患者治疗前CD4+CD152明显高于对照组(P<0.05);观察组慢性丙型肝炎患者治疗前CD8+CD152与对照组无明显差异(P>0.05);观察组患者经过治疗后CD4+CD152明显降低(P<0.05),CD8+CD152+无明显变化(P>0.05);治疗后观察组CD4+CD152+、CD8+CD152与对照相比较无明显差异(P>0.05);治疗前HCV-RNA阳性率为82.5%(33/40),治疗后为17.5%(7/40),治疗后HCV-RNA阳性率明显降低(P<0.05)。结论外周血T细胞CD28、CD152水平变化能反映慢性丙型肝炎患者HCV RNA复制情况及免疫系统状态。

Objective To investigate the changes of CD28 ,CD152 on surface of peripheral blood T ceils after treatment in patients with chronic hepatitis C for providing a basis in the clinical treatment of chronic hepatitis C. Methods Forty cases of chronic hepatitis C （observation group） and 40 healthy controls were enrolled in this study. The levels of CD28 and CD152 on CD4 ＋ lymphocyte and CD8 ＋ lymphocyte surface were detected by flow cytometry. Results The levels of CD4 ＋ CD28 and CD8 ＋ CD28 in patients with chro- nic hepatitis C were significantly lower than those in healthy controls before treatment （ P 〈 0.05 ）. The levels of CD4 ＋ CD28, CD8 ＋ CD28 increased significantly after treatment in observation group （P 〈 0.05 ）. There was no significant difference in CD4 ＋ CD28, CD8 ＋ CD28 between observation group and control group after treatment（P 〉 0.05 ）. The level of CD4 ＋ CD152 in observation group was sig- nificantly higher than that in control group before treatment （P 〈 0.05）. There was no significant difference in CD8 ＋ CD152 before treatment between observation group and control group （ P 〉 0.05 ）. The level of CD4 ＋ CD152 decreased significantly in observation group after treatment （P 〈0.05 ）,while CD8 ＋ CD152 ＋ had no significant change （P 〉 0.05 ）. There was no significant difference in CD4 ＋ CD152 ＋ , CD8 ＋ CD152 between observation group and control group （ P 〉 0. 05 ）. The positive rate of HCV-RNA was 82.5% （33/40） before treatment, and significantly decreased after treatment [ 17.5 % （7/40）, P 〈 0.05 ]. Conclusion The change of T cells in the peripheral blood CD28, CD152 levels can determine the HCV RNA replication and immune system of patients with chronic hepatitis C.