乙型肝炎肝硬化患者外周血T淋巴细胞亚群和NK细胞的变化及临床意义

The changes and clinical significance of T cell subsets and NK cells from peripheral blood in patients with HBV associated cirrhosis

目的探讨乙肝肝硬化患者外周血中T淋巴细胞亚群及NK细胞含量的变化,了解乙肝肝硬化患者的免疫功能状况。方法乙肝肝硬化患者81例,并按Child-Pugh分为A、B、C三级,26例健康者作为健康对照,采用流式细胞仪检测血清中CD3+T淋巴细胞、CD4+T淋巴细胞、CD8+T淋巴细胞和NK细胞的含量。结果 Child-Pugh B级和C级的乙肝肝硬化患者外周血中CD3+T淋巴细胞、CD4+T淋巴细胞和NK细胞的含量明显降低,而CD8+T淋巴细胞含量升高,与健康对照组比较,差异有统计学意义(P<0.05),而Child-Pugh A级的乙肝肝硬化患者T淋巴细胞亚群变化不明显(P>0.05)。结论乙肝肝硬化患者的机体免疫功能低下,并且随着其肝功能下降及Child-Pugh分级的增加而显著,对判断乙肝肝硬化患者的病情及预后具有重要的临床价值。

Objective To explore the changes of T cell subsets and NK cells from peripheral blood in patients with HBV associated cirrhosis,for further understanding the immune status in these patients.Methods Eighty-one patients with HBV associated cirrhosis were recruited as the experimental group,which was classified into A,B,C levels according to the Child-Pugh scores. Meanwhile,26 healthy volunteers were chosen as the normal control group. Levels of CD3＋T cells,CD4^＋T cells,CD8＋T cells and NK cells from peripheral blood of the two groups were tested by flow cytometry.Results Compared to the control group,levels of CD3^＋ T cells,CD4＋ T cells and NK cells significantly decreased and level of CD8^＋ T cells significantly increased from peripheral blood in patients with HBV associated cirrhosis of Child-Pugh B and C groups （P〈0.05）. However,there was no obvious change of T cell subsets and NK cells in Child-Pugh A group. Conclusions The immune function of HBV associated cirrhosis is poor. Disorder or decrease of immune function in these patients was associated with the gradual aggravation of liver function and Child-Pugh score,which has an important clinical value in assessing the immune function,disease progression and prognosis of HBV associated cirrhosis.