慢性乙型肝炎患者外周血CD4^+IL-17A^+IFN-γ^+T细胞的变化及临床意义

Clinical significance of CD4^+IL-17A^+IFN-γ^+T cell on patients infected with chronic hepatitis B virus

目的研究CD4+IL-17A+IFN-γ+T细胞在慢性乙型肝炎患者中的作用及意义。方法采用流式细胞术检测40例慢性HBV感染患者和15例健康志愿者外周血CD4+IL-17A+IFN-γ+T细胞数量,同时采用ELISA法检测血清IL-17A和IFN-γ含量。结果慢性HBV感染重型患者(CSHB)外周血中CD4+IL-17A+IFN-γ+T细胞含量和血清IL-17A含量最高,与慢性HBV感染轻、中度患者(CHB-LM)和慢性HBV感染无症状携带者(AsC)及健康志愿者(HV)比较差异有统计学意义(P均<0.05)。CSHB和CHB-LM患者血清IFN-γ含量均明显低于AsC组和HV组,差异有统计学意义(P均<0.05),AsC组和HV组患者IFN-γ含量差异无统计学意义(P>0.05)。Pearson相关性分析显示,慢性HBV轻、中度患者及慢性HBV重型患者血清IL-17A水平与CD4+IL-17A+IFN-γ+T细胞含量呈正相关(P均<0.05)。慢性HBV无症状携带者,慢性HBV轻、中度患者和慢性HBV重型患者血清IFN-γ含与血清IL-17A含量及外周血CD4+IL-17A+IFN-γ+T细胞含量均无明显相关性(P均>0.05)。结论CD4+IL-17A+IFN-γ+T细胞在慢性乙型病毒性肝炎不同疾病阶段存在差异,可能在HBV发生、发展过程中发挥重要作用。

Objective To study clinical significance of CD4^＋IL-17A^＋IFN-γ^＋T cell in patients with ehmnie hepatitis B. Methods Flow eytometry was used to detect CD4^＋IL-17A^＋IFN-γ^＋T cell eount in peripheral blood from 40 ehmnie hepatitis B patients and 15 healthy volunteers,and ELISA was also used to detect serum IL-17A and IFN-γ levels. Results Compare with chronic hepatitis B with low and moderate patients, asymptomatie carriers of chronic hepatitis B and healthy volunteer,the percents of CD4^＋IL-17A^＋IFN-γ^＋T cells and serum IL-17A levels in chronic severe hepatitis B patients were significantly increased, but serum IFN-γ levels were significantly decreased. On chronic severe hepatitis B patients CD4~IL-17A＋IFN-,/＋T cell count is positively correlated to serum IL-17A levels,not to IFN-γ levels. Conclusion CD4^＋IL-17A^＋IFN-γ^＋T cell may play a more important role in chronic HBV infection.