辅助性T细胞17在不同程度HBV感染者外周血中的表达情况及其与HBV-DNA和ALT的相关性

Expression of T helper cell 17 in peripheral blood of patients with different degrees of HBV infection and its correlation with HBV-DNA and ALT

目的探讨辅助性T细胞17(Th17)在不同程度HBV感染者中的表达情况及其与HBV-DNA和ALT的关系。方法采用流式细胞仪检测86例HBV感染者(中度慢性乙型肝炎患者31例,重度慢性乙型肝炎患者25例,HBV相关性肝硬化患者16例,HBV相关性肝癌患者14例)和22例健康者外周血中Th17占CD4+T细胞的比例、白细胞介素17(IL-17)的水平,同时检测ALT及HBV-DNA水平。结果不同程度HBV感染者外周血Th17细胞占CD4+T细胞的比例和IL-17、ALT水平均明显高于健康对照组(P<0.05)。中度和重度慢性乙型肝炎组患者外周血Th17细胞占CD4+T细胞的比例及IL-17的表达水平均明显低于HBV相关性肝硬化组、HBV相关性肝癌组(P<0.05),但中度和重度慢性乙型肝炎组组间比较,差异无统计学意义(P>0.05)。HBV相关性肝硬化组患者的Th17细胞占CD4+T细胞的比例及IL-17的表达水平亦显著低于HBV相关性肝癌组(P<0.05)。不同程度HBV感染者外周血Th17细胞占CD4+T细胞的比例与HBV-DNA水平呈负相关(P<0.05),与ALT呈正相关(P<0.05)。结论不同程度HBV感染者外周血中Th17细胞及IL-17表达失调,增多的Th17细胞可能促进了肝细胞的损伤及炎症,并与HBV感染病情进展密切相关。

Objective To investigate the expression of T helper cell 17 （Th17） in the patients with different degrees of HBV infection and its correlation with HBV-DNA and ALT. Methods A total of 86 patients with HBV infection [ including 31 with moderate chronic hepatitis B （CHB） ,25 with severe CHB, 16 with HBV-related cirrhosis and 14 with HBV-related liver cancer] and 22 healthy individuals were enrolled. Flow eytometry was used to detect the ratio of Th17 to CD4 ＋ T cell, the levels of interleukin 17 （ IL-17 ） and ALT in the peripheral blood in all subjects, and the level of HBV-DNA was detected as well. Results The ratio of Th17 to CD4 ＋T cells,the levels of 1L-17 and ALT in the patients with different degrees of HBV infection were significantly higher than those in the healthy control group （P 〈 0.05 ）. Patients with moderate or severe CHB had significantly lower ratio of Th17 to CD4 ＋T cells and significantly lower expression level of IL-17 compared to patients with HBV-related cirrhosis or HBV-related liver cancer （ P 〈 0.05 ） , but there was no significant difference in the ratio or IL-17 expression level between patients with moderate CHB and patients with severe CHB（ P 〉 0.05 ）. Patients with HBV-related cirrhosis had significantly lower ratio of 31317 to CD4＋ T cells and significantly lower expression level of IL-17 compared to patients with HBV-related liver cancer （P 〈0.05）. In the patients w different degrees of HBV infection,the ratio of 33117 to CD4＋ T cells in the peripheral blood negatively correlated with the level of HBV-DN （P 〈 0. 05） ,and positively correlated with ALT（P 〈 0. 05 ）. Conclusion For the patients with different degrees of HBV infection,the expressions of Th17 ceils and IL-17 in the peripheral blood are in disorder. The increase of Th17 cells might promote the damage and inflammation of liver cells ,and is closely related to the disease progression of HBV infection.