慢性HBV感染者外周血T细胞亚群与病毒载量、HBeAg的相关性分析

The correlation between T lymphocyte subsets in peripheral blood and HBV DNA levels as well as HBeAg in patients with chronic hepatitis B virus infection

目的分析慢性HBV感染者外周血T细胞亚群与病毒载量、HBeAg的相关性。方法以40例慢性乙型肝炎(CHB)、35例慢性重型乙型肝炎(CSHB)、30例肝硬化(LC)及32例正常对照者为研究对象,采用流式细胞仪和荧光定量PCR法分别检测各组外周血T细胞亚群、HBV DNA载量。结果 CHB组仅CD+4亚群明显降低,与对照组比较,差异有统计学意义(P<0.05);CSHB及LC组CD+3、CD+4亚群、CD+4/CD+8比值呈逐渐降低趋势,CD+8亚群呈逐渐增高趋势,与对照组比较差异有统计学意义(P<0.05)。HBV DNA载量与CD+4亚群、CD+4/CD+8比值呈负相关(r=-0.638,-0.778,P<0.05),与CD+8亚群呈正相关(r=0.647,P<0.05),与CD+3无关。与HBeAg阳性患者比较,HBeAg阴性患者外周血CD+3+、CD+4和CD+8亚群显著降低(P<0.05)。结论慢性HBV感染者随着疾病加重细胞免疫功能进行性降低,与病毒复制水平密切相关,这是导致疾病慢性化的原因之一。外周血T细胞亚群变化趋势可为判断疾病转归及预后提供可靠指标。

Objective To investigate the relationship between T-lymphocyte subsets and HBV DNA levels ,HBeAg in patients with chronic hepatitis B virus （ HBV） infection.Methods The 40 cases of chronic hepatitis （ CHB）,35 cases of chronic severe hepatitis B （ CSHB） ,30 cases of liver cirrhosis （ LC） and 32 healthy subjects were enrolled in the study .The T lymphocyte subsets and HBV DNA load in peripheral blood were detected by flow cytometry and fluorescence quantitative PCR for all the patients and healthy subjects .Results The CD^4＋subset was significantly decreased in CHB group ,as compared with that in control group （ P 〈0.05）;the CD^3＋,CD^4＋subsets,the ratio of CD^4＋/CD^8＋in CSHB group and LC group were gradually decreased,however,CD^8＋subset was gradually increased ,as compared with those in control group （ P 〈0.05）.HBV DNA load was negatively correlated to CD 4＋subset,ratio of CD^4＋/CD^8＋（ r =-0.638,-0.778, P 〈0.05）,however,which was positively correlated to CD^8＋subset （ r =0.647, P 〈0.05）,moreover,which was not related with CD 3＋subset.As compared with those of patients with positive HBeAg ,the CD^＋3 subset ,CD^4＋subset and CD 8＋subset in peripheral blood of patients with negative HBeAg were significantly decreased （ P 〈0.05 ）.Conclusion The cellular immune function in patients with chronic HBV infection is progressively decreased with the aggravation of disease condition , which is closely correlated to the levels of virus replication ,and it is one of the reasons that results in chronicity of disease .The changing trend of T lymphocyte subsets in peripheral blood can be regarded as a reliable index for evaluating disease ’s prognosis.