慢性乙型肝炎患者血清HBV DNA水平与细胞毒性T淋巴细胞表面PD-1表达的关系和意义

Relationship between serum HBV DNA level and cytotoxic T lymphocyte surface PD-1 expression in patients with chronic hepatitis B and its significance

目的 探讨慢性乙型肝炎（CHB）患者血清HBV DNA水平与HBV特异性CTL表面程序性死亡受体-1（PD-1）表达的关系和意义.方法 将133例CHB患者根据血清HBV DNA水平分为甲、乙两组,甲组70例（52.63％）,HBV DNA水平为104～105拷贝/ml,乙组63例（47.37％）,HBVDNA水平分107 ～ 108拷贝/ml,对两组患者作HBV特异性CTL、非特异性CTL,HBV特异性CTL表面PD-1表达和肝功能的比较.结果 甲组HBV DNA水平为（5.03±1.01）log10拷贝/ml,低于乙组（7.59±0.99） log10拷贝/ml,t=11.23,P＜0.01,HBV特异性CTL表面PD-1表达（26.32±2.56）％,低于乙组（39.35 ±2.86）％,t=18.69,P＜0.01,HBV特异性CTL （0.37±0.02）％,高于乙组（0.22±0.02）％,t=25.80,P＜0.01,非特异性CTL（16.26 ±2.17）％,低于乙组（19.94±2.47）％,t=3.19,P＜0.01,ALT （259.16 ±85.11） U/L,低于乙组（501.16±86.15） U/L,t=15.10,P＜0.01,TBil（27.99±6.13）μmol/L,低于乙组（44.86±9.51） μmol/L,t=3.92,P＜0.01.结论 CHB患者HBV DNA水平低者,HBV特异性CTL表面PD-1表达也低,HBV特异性CTL水平高,HBV DNA水平高者,HBV特异性CTL表面PD-1表达也高,导致HBV特异性CTL水平降低,并启动非特异性CTL,引起肝功能损害加重.

Objective To explore the relationship between serum HBV DNA level and HBV specific CTL surface programmed death receptor-1 （PD-1） expression in patients with chronic hepatitis B （CHB） and its significance.Methods 133 cases of CHB patients were divided into group A and group B according to their serum HBV DNA levels,70 cases（52.63%）in group A with HBV DNA level 104-105 copies/ml,63 cases（47.37%）in group B with HBV DNA level 107-10s copies/ml,HBV specific CTL,nonspecific CTL,HBV specific CTL surface PD-1 expression and liver functions of the two groups were compared.Results HBV DNA levels of group A were （5.03 ± 1.01） log10 copies/ml,lower than those of group B （7.59 ± 0.99） log10 copies/ml,t =11.23,P 〈 0.01 ; HBV specific CTL surface PD-1 expression of group A was （26.32 ± 2.56） %,lower than that of group B （39.35 ± 2.86） %,t =18.69,P 〈 0.01 ; HBV specific CTL of group A was（0.37 ± 0.02） %,higher than that of group B （0.22 ± 0.02） %,t =25.80,P 〈 0.01 ; nonspecific CTL of group A was （16.26 ± 2.17） %,lower thanthat of group B （19.94 ± 2.47） %,t=3.19,P 〈0.01; ALTofgroupA was （259.16 ±85.11）U/L,lower than that of group B （501.16 ±86.15）U/L,t=15.10,P 〈0.01; TBil of group A was （27.99 ±6.13） μ mol/L,lower than that of group B （44.86 ± 9.51） μ mol/L,t =3.92,P 〈 0.01.Conclusions CHB patients with lower HBV DNA level have lower HBV specific CTL surface PD-1 expression and higher HBV specific CTL level; CHB patient with higher HBV DNA level have higher HBV specific CTL surface PD-1 expression,resulting in lower HBV specific CTL level and starting nonspecific CTL,thus aggravating damage of liver functions.