乙肝肝硬化病毒基因型与细胞毒性T淋巴细胞表面程序性死亡受体-1表达的关系

Relationship between viral genotypes and specific cytotoxic T lymphocyte surface programmed death receptor-1 expression in patients with cirrhotic hepatitis B

目的探讨乙型肝炎肝硬化患者不同乙型肝炎病毒(HBV)基因型与外周血HBV特异性细胞毒性T淋巴细胞(CTL)表面程序性死亡受体-1(PD-1)表达的关系和意义。方法 66例人白细胞抗原(HLA)-A2阳性的乙型肝炎肝硬化患者作HBV基因型检测,比较B、C基因型感染者之间HBV特异性CTL表面PD-1表达水平、HBV特异性CTL水平、HBV DNA水平和肝功能的差别。结果 66例乙型肝炎肝硬化患者中,C基因型44例(66.67%),B基因型21例(31.82%),B、C混合型1例(1.52%),C基因型感染者的HBV特异性CTL表面PD-1表达水平高于B基因型感染者(t=12.07,P<0.01),HBV特异性CTL水平低于B基因型感染者(t=13.54,P<0.01),HBV DNA水平高于B基因型感染者(t=7.46,P<0.01),丙氨酸转氨酶(ALT)高于B基因型感染者(t=2.54,P<0.05),TBil高于B基因型感染者(t=3.12,P<0.01)。结论与乙型肝炎肝硬化B基因型感染者相比较,C基因型感染者的HBV特异性CTL表面PD-1表达水平较高,导致HBV特异性CTL水平较低,引起HBV DNA水平较高,肝功能损害较重。

[ Objective ] To explore the relationship between different HBV genotypes and peripheral blood HBV specific cytotoxic T lymphocyte （CTL） surface programmed death receptor-1 （PD-1） expression and its significance in patients with cirrhotic hepatitis B. [ Methods ] HBV genotypes of 66 cases of cirrhotic hepatitis B with positive human leukocyte antigen （HLA）-A2 were tested. HBV specific CTL surface PD-1 expression level, HBV specific CTL level, HBV DNA level and liver functions of patients infected with genotype B and C were compared. [ Re- stilts] Of 66 patients with cirrhotic hepatitis B, 44 cases （66.67%） were infected with genotype C, 21 cases （31.82%） were infected with genotype B and 1 case （1.52%） was mixed type of B and C. Compared with patients infected with genotype B, HBV specific CTL surface PD-1 expression level was higher （t=12.07, P 〈 0.01）, HBV specific CTL level was lower （t = 13.54, P 〈 0.01）, HBV DNA level was higher （t = 7.46, P 〈 0.01）, ALT was higher （t = 2.54, P 〈 0.05）, and TBil was higher in patients infected with genotype C （t = 3.12, P 〈 0.01）. [ Conclusions ] Compared with cirrhotic hepatitis B patients infected with genotype B, HBV specific CTL surface PD-1 expression level of patients infected with genotype C is higher, resulting in lower HBV specific CTL level, causing higher HBV DNA level and more serious damage of liver functions.