慢性乙型肝炎患者及 HBV 携带者 D8^＋ T 细胞表面活化分子 CD38和人类白细胞抗原-DR表达研究

Expression of CD38 and HLA -DR on CD ＋8 T cells in patients with chronic hepatitis B and HBV carriers

目的：研究慢性乙肝（CHB）患者阿德福韦酯治疗前后及 HBV 携带者 CD8^＋ T 细胞表面活化分子 CD38和人类白细胞抗原-DR（HLA-DR）表达情况，并探讨其与疾病进展的关系。方法收集32例经阿德福韦酯治疗的 CHB 患者、31例 HBV 携带者和28例健康对照者，采集 CHB 患者治疗前后及 HBV 携带者和健康对照外周血。用流式细胞术检测 CD4^＋和 CD8^＋ T 细胞数量和比例，以及 CD8^＋ CD38^＋和 CD8^＋ HLA-DR ＋T 细胞比例。结果CHB 患者治疗前 CD8^＋ CD38^＋ T 细胞比例为（58．4±12．7）％，显著高于 HBV 携带者的（46．8±8.5）％和健康对照组的（24．3±7．9）％，阿德福韦酯治疗后显著降低（34．2±9．4）％，HBV 携带者 CD8^＋ CD38^＋ T细胞比例高于健康对照组（F ＝8．27，P ＝0．000）。CHB 患者治疗前 CD8^＋ HLA-DR ＋T 细胞比例为（43．3±12.5）％，显著高于健康对照组的（9．8±5．7）％（F ＝13．48，P ＝0．000），但与 HBV 携带者的（37．1±11．3）％差异无统计学意义，阿德福韦酯治疗后显著下降，仍高于正常水平（P ＜0．05）。结论HBV 感染可以引起CD8^＋ T 活化水平显著升高，阿德福韦酯抗病毒治疗能够降低 CD8^＋ T 的活化。CD8^＋ T 活化水平是良好的 HBV 感染病情评价指标。

Objective To determine the expression of CD38 and HLA -DR on CD8^＋ T cells in patients with chronic hepatitis B and HBV carriers,and to disscuss the relation between immune activation and disease progression of HBV infection.Methods Thirty -two chronic hepatitis B patients receiving adefovir dipivoxil treatment,31 HBV carriers and 28 normal controls were collected.The counts of CD4^＋ and CD8^＋ T cells and the percentage of CD8^＋ CD38^＋ and CD8^＋ HLA -DR ＋T cells were tested by flow cytometry.HBV DNA and liver function were tested in the central laboratory of our hospital.Results The percentage of CD8^＋ CD38^＋ T cells in CHB patients was （58.4 ±12.7）%,and was higher than that in HBV carriers （46.8 ±8.5）% and normal controls （46.8 ±8.5）%,and decreased after adefovir dipivoxil treatment （34.2 ±9.4%）（F =8.27,P =0.000）.The percentage of CD8^＋ CD38^＋ T cells in HBV carriers was （43.3 ±12.5）%,and was much higher than that in normal controls （9.8 ±5.7）%（F =13.48,P =0.000）.The percentage of CD8^＋ HLA -DR ＋ T cells in CHB patients was higher than that in normal controls,but similar to that in HBV carriers （37.1 ±11.3）%.CD8^＋ HLA -DR ＋ T cells in CHB patients also decreased after adefovir dipivoxil treatment （P 〈0.05 ）.Conclusion Our study demonstrates that activation of CD8^＋ T cells is increased in HBV infection but decreased by adefovir dipivoxil treatment.The percentages of CD8^＋ CD38^＋ and CD8 ＋HLA -DR ＋T are good markers for disease progression of HBV infection.