丙型肝炎患者外周血淋巴细胞亚群变化特点

Changes of lymphocyte subsets in peripheral blood of patients with hepatitis C

目的观察丙型肝炎患者外周血淋巴细胞亚群变化特点。方法对219例丙型肝炎患者和66例健康对照者分别采用流式细胞术(FCM)检测外周血CD45+淋巴细胞,T淋巴细胞(CD45+CD3+、CD45+CD3+CD4+、CD45+CD3+CD8+),B淋巴细胞(CD45+CD3-CD19+),NK细胞(CD45+CD3-CD16+56+)百分比和细胞绝对计数。结果在丙型肝炎病毒(HCV)慢性感染到肝硬化失代偿过程中,淋巴细胞亚群绝对计数出现逐渐下降趋势。慢性丙型肝炎组较健康对照组CD4+T细胞、CD8+T细胞、NK细胞绝对计数明显降低(P<0.05)。丙型肝炎肝硬化在早期组和失代偿期组淋巴细胞各亚群计数均较慢性丙型肝炎组明显降低(P<0.01),而失代偿期组明显低于早期组(P<0.01)。B淋巴细胞百分比以及CD4/CD8比值在慢性感染到肝硬化失代偿过程中出现升高趋势,并在丙型肝炎肝硬化早期和失代偿期时变化明显(P<0.01,P<0.05),NK淋巴细胞百分比出现明显降低趋势(P<0.01)。结论 HCV感染慢性化至肝硬化早期和失代偿期的过程中,外周血CD8+T细胞、CD4+T细胞、NK细胞减少;B细胞百分比、CD4/CD8比值升高。

Objective To investigate the changes of lymphocyte subsets in the peripheral blood of patients with hepatitis C.Methods A total of 219 patients with hepatitis C and 66 healthy individuals served as normal controls were enrolled in the study. The proportions of T-lymphocytes（ CD45＋CD3＋,CD45＋CD3＋CD4＋,CD45＋CD3＋CD8＋）,B-lymphocytes（ CD45＋CD3-CD19＋）,NK-lymphocyte（ CD45＋CD3-CD16＋56＋） in peripheral blood were detected by flow cytometry.Results The count of peripheral lymphocyte subsets of patients with hepatitis C decreased from the stage of chronic infection to decompensated cirrhosis. The numbers of CD4＋,CD8＋and NK lymphocytes of patients with chronic hepatitis C were significantly lower than those in healthy individuals（ P〈 0. 05）. In the early and decompensated stage of hepatic cirrhosis,the numbers of lymphocyte subsets of patients were significantly lower than those in patients with chronic hepatitis C（ P〈0. 01）,and they were significantly lower in decompensated cirrhosis than in early cirrhosis（ P〈0. 01）. The proportion of B lymphocyte and CD4 /CD8 ratio of patients increased from chronic infection to decompensated cirrhosis. Compared with chronic infection,the proportion of B lymphocyte and CD4 /CD8 ratio in early and decompensated cirrhosis increased significantly（ P〈0. 01 or P〈 0. 05）,while the proportion of NK lymphocyte was significantly reduced（ P〈0. 01）. Conclusion From the stage of chronic infection to decompensated cirrhosis,patients with hepatitis C were found with the decreased numbers of CD4＋T,CD8＋T and NK lymphocytes,and the increased proportion of B lymphocyte and CD4 /CD8 ratio.