不同临床类型乙型病毒性肝炎患者淋巴细胞亚群的差异性分析

Analysis of Different Subsets of Lymphocytes in Different Clinical Types of Hepatitis B Patients

目的研究分析不同临床类型乙型病毒性肝炎(HBV)患者淋巴细胞亚群的差异性及其临床意义。方法采用流式细胞术检测乙肝病毒携带者、慢性乙型肝炎、急性乙型肝炎、乙型肝炎肝硬化(LC)、原发性肝癌(HCC)患者外周血T淋巴细胞亚群(CD3+、CD4+、CD4+/CD8+)、NK细胞(CD16+CD56+)所占淋巴细胞百分比,并与健康对照组比较。结果与健康对照组比较,乙型肝炎病毒携带者、急性乙型肝炎患者CD3+、CD4+T细胞百分比及CD4+/CD8+比值无统计学差异(P>0.05),慢性乙肝肝炎、LC和HCC患者CD3+、CD4+T细胞百分比及CD4+/CD8+比值逐步递减(P<0.05),以HCC患者下降最为显著。与健康对照组相比,急性乙型肝炎、慢性乙型肝炎患者CD8+T细胞计数显著升高(P<0.05),LC、HCC患者CD8+T细胞则显著下降(P<0.05)。乙型肝炎病毒携带者、急性乙型肝炎患者NK细胞计数与对照组相比,差异无统计学意义(P>0.05),慢性乙型肝炎患者NK细胞计数显著增加(P<0.05),LC、HCC患者NK细胞计数则下降显著(P<0.05)。结论 HBV感染者临床类型不同,各淋巴细胞亚群免疫调节差异有统计学意义,对指导临床治疗及评判预后有一定的临床价值。

Objective To research and analysis the difference and clinical significance of lymphocyte subsets with different types of clinical hepatitis B （HBV） in patients. Methods Peripheral blood T lymphocyte subsets （ CD3＋ , CD4 ＋ , CD4＋ / CD8 ＋） and NK cells （CD16 ＋ CD56 ） accounts for the lymphocyte percentage which in patients with the hepatitis B virus carriers, chronic hepatitis B, acute hepatitis B, liver cirrhosis （LC） , hepatocellular carcinoma （HCC） are detected by flow - cytometry, and compared with the healthy con- trol group. Results Compared with the heahhy control group, the CD3 ＋ , CD4＋ T lymphocyte percentage and CD4 ＋ / CD8 ＋ ratio which in the hepatitis B virus carriers, acute hepatitis B patients are no significant difference （P 〉 O. 05） ; The CD3 ~ , CD4 ＋ T cell percentage and CD4 ~/CD8 ~ ratio in patients with chronic hepatitis B, LC and HCC decreased significantly （ P 〈 0.05 ） , with the most significant decline in HCC patients. Compared with the healthy control group, The CD8 ＋ T cell count increase significantly which in the patients with acute hepatitis B and chronic hepatitis B （P 〈 0.05） ,hut decrease significantly which in the patients with LC, HCC （P 〈 0.05 ）. Com- pared with the healthy control group, the NK cell count was not significantly difference which in patients with Hepatitis B virus carriers, a- cute hepatitis B patients vs control group （P 〉 0.05） , NK cell count increased significantly which in patients with chronic hepatitis B, but decreased significantly in LC and HCC patients（P 〈 0.05）. Conclusion The HBV infection in different clinical types which have different immune regulation in lymphocyte subsets. This may guide the clinical treatment and evaluation of prognosis.