HEV相关肝衰竭患者CD4^＋／CD8^＋比值变化与预后的关系

目的探讨戊型肝炎病毒（HEV）相关肝功能衰竭患者CD4^＋T细胞、CD8^＋T细胞、CD4^＋／CD8^＋比值的变化及与预后的关系方法应用流式细胞计数分别对戊型肝炎病毒相关肝功能衰竭（HEV-LF）患者15例，普通急性戊型肝炎（AHE）患者21例和健康对照者20例外周血中CD4^＋T细胞、CD8^＋T细胞水平进行检测，同时检测TBiL、PTA等指标。15例HEV-LF患者根据预后不同分为好转组与死亡组，预后相关危险因素用Logistic回归分析结果。结果HEV-LF组与AHE组CD4^＋T细胞频数分别为（30．72±11．14）％，（32．61±8．96）％，比健康对照组（37．95±2．03）％明显下降，差异有统计学意义（P〈0．05），两组间比较差异无统计学意义（P〉0．05）。HEV-LF组与AHE组CD8^＋T细胞频数分别为（31．15±8．69）％，（24．23±7．50）％，比健康对照组（19．14±5．33）％明显升高，差异有统计学意义（P〈0．05）；两组间比较也有统计学意义（P〈0．05）。HEV-LF组与AHE组CD4^＋／CD8^＋比值分别为（1．06±0．47）、（1．54±0．90），比健康对照组（2．13±0．88）明显降低，差异有统计学意义（P〈0．05），两组间比较也有统计学意义（P〈0．05）。CD4^＋／CD8^＋比值水平降低是HEV-LF组患者预后的危险因素。结论HEV-LF、AHE患者存在不同程度的细胞免疫功能紊乱，其中CD4^＋／CD8^＋比值水平降低是HEV-LF组患者预后的危险因素。

Objective To investigate the changes of CD4^＋ T cell, CD8^＋ T cell and ratio of CD4^＋/CD8^＋ in patients with hepatitis E virus （ HEV ） related liver failure and their relationship with prognosis. Methods Using flow cytometry respectively, peripheral blood CD4^＋ T cell, CD8^＋ T cell were detected in 15 cases of hepatitis E virus related liver failure patients （HEV-LF）, 21 cases of common acute hepatitis E patients （ AHE ） and 20 cases of healthy controls, as well as TBIL PTA and others. 15 patients with HEV-LF were divided into improvement group and death group according to different prognosis, and prognostic risk factors using logistic regression analysis. Results HEV-LF and AHE group of CD4^＋ T cell frequency were （30.72±11.14） %, （32.61±8.96） %, which were significantly decreased compared with the healthy control group （37.95±2.03） % （P〈0.05） , while there was no significant difference between the two groups of patients （P〉0.05 ） . CD8^＋ T cell frequency in HEV-LF group and AHE group were （ 31.15 ± 8.69 ） % and （ 24.23 ± 7.50 ） %, respectively, which both increased significantly compared with healthy control group（ 19.14%± 5.33%）, （P〈0.05 ） ; while there was statistical significance between two groups of patients （P〈0.05 ） . The ratio of CD4^＋/CD8^＋ were （ 1.06 ± 0.47 ） , （ 1.54 ± 0.90 ） in HEV-LF group and AHE group, respectively, while in the healthy control group, it was 2.13 ± 0.88, showing significant decrease （P〈0.05 ） , also statistical significance were between the two groups of patients （P〈0.05 ） . Conclusion Reduction of CD4^＋/CD8^＋ ratio is a risk factor for the prognosis ofpatients withHEV-LE HEV-LF andAHE have differentlevels of cellular immune function disorder, and the reduction ofratio of CD4^＋/CD8^＋ is a risk factor for the prognosis of patients with HEV-LE