外周血DNT细胞和T细胞亚群检测在乙型肝炎病毒感染者诊断中的意义

Changes of peripheral blood double negative T cells and T cell subsets in patients with hepatitis B virus infection

目的探讨乙型肝炎病毒感染者外周血CD3+CD4-CD8-T细胞(DNT)和T细胞亚群的变化及意义。方法使用流式细胞仪检测136例乙型肝炎病毒感染者,包括33例无症状携带者、28例急性乙型肝炎患者、28例轻度慢性乙型肝炎患者、25例中度慢性乙型肝炎患者、22例重度慢性乙型肝炎患者和39例健康人外周血DNT细胞及T细胞亚群。结果健康人群和急性乙型肝炎患者外周血DNT细胞比例分别为(4.82±3.43)%和(4.75±2.71)%,显著低于无症状携带者[(5.43±3.31)%,P<0.05]和慢性乙型肝炎患者(P<0.05);轻度慢性乙型肝炎患者DNT细胞比例为(7.97±4.12)%,显著低于重度慢性乙型肝炎患者[(11.36±5.01)%,P<0.05];中度慢性乙型肝炎患者DNT细胞比例为(8.41±4.93)%,也显著低于重度慢性乙型肝炎患者(P<0.05);健康人、急性乙型肝炎患者和无症状携带者之间T淋巴细胞亚群分布无明显差异,但随着慢性乙型肝炎患者病情加重,外周血CD3+、CD3+CD4+CD8-细胞比例降低(P<0.05),CD3+CD4-CD8+细胞比例升高(P<0.05)。结论外周血DNT细胞比例的升高与乙型肝炎病毒感染者慢性化及慢性乙型肝炎患者的疾病进程有关。

Objective To investigate the changes of peripheral blood CD3 ＋CD4 -CD8 -T cells （double negative T,DNT） and T lymphocyte subsets in patients with hepatitis B virus （HBV） infection. Methods The peripheral blood DNT cells and T lymphocyte subsets were detected by flow cytometry in 136 HBV cases including asymptomatic carriers （ASCs,n=33）,acute hepatitis B （AHB,n=28）,mild chronic hepatitis B （n=28）, moderate chronic hepatitis B（n=25）,severe chronic hepatitis B（n=22） and healthy persons（n=39）. Results The percentages of DNT cells in healthy persons and in patients with AHB were （4.82 ±3.43）% and （4.75 ±2.71）%, respectively,both of which were significantly lower than that in ASCs [（5.43 ±3.31）%,P〈0.05];The percentage of DNT cells in patients with mild CHB was （7.97 ±4.12）%, significantly lower than in patients with severe CHB [（11.36±5.01）%,P〈0.05],and the percentage of DNT cells in patients with moderate CHB was （8.41±4.93）%,also significantly lower than in patients with severe CHB （P〈0.05）;There were no differences in percentages of T lymphocyte subsets among health persons,patients with acute hepatitis B and ASCs;The percentages of CD3＋ and CD3＋CD4＋CD8- cells decreased（P〈0.05） and the percentage of CD3＋CD4-CD8＋ cells increased （P〈0.05） in patients with chronic severe hepatitis B. Conclusions The increase in peripheral blood DNT cells is associated with the chronicity of illness in patients with CHB.