干扰素治疗对慢性乙肝患者CD4^+ CD25^+调节性T细胞水平的影响研究

Effect of CD4^+ CD25^+ regulatory T cell level of chronic hepatitis B during interferon theraping

目的探讨慢性乙型肝炎患者在干扰素抗病毒治疗中外周血调节性T细胞的变化及临床意义。方法选择2013年1月~2015年1月在我院行干扰素抗病毒治疗的慢性乙肝患者60例及同时期体检的健康成人20例,分别于治疗前、治疗后第12、24、36、48周及停药后24周收集患者的外周血,比较外周血中CD4^+CD25^+调节性T细胞(Tregs)、血清HBV-DNA载量以及谷氨酸-丙酮酸转氨酶(ALT)的变化。结果治疗前,完全应答组、部分应答组以及无应答组外周血CD4^+CD25^+调节性T细胞比例、ALT含量以及HBV-DNA载量组间比较差异无统计学意义(P>0.05),但均显著高于健康对照组,差异有统计学意义(P<0.05);治疗后,完全应答组和部分应答组患者各时间段Tregs比例均较治疗前显著下降(P<0.05);在治疗及停药期间,完全应答组和部分应答组患者的Tregs比例一直在下降;治疗期间HBV-DNA转阴患者的Tregs比例逐步下降且显著低于未转阴的患者(P<0.05);治疗期间血清学转换的患者Tregs比例逐步下降且显著低于未转换的患者(P<0.05)。结论慢性乙肝患者在接受干扰素抗病毒治疗期间及治疗后,其外周血调节性T细胞比例下降,且越早出现下降的患者其治疗后血清转阴的可能性越大。

Objective To investigate the changes and clinical significance of peripheral blood regulatory T cells in chronic hepatitis B patients treated with interferon. Methods 60 patients with chronic hepatitis B who were treated with interferon and 20 healthy adults were selected from January 2013 to January 2015 in our hospital. Peripheral blood was collected before treatment and 12th weeks, 24th weeks, 36th weeks, 48th weeks after treatment and 24 weeks after withdrawal, the chan.ges of CD4^＋CD25^＋ regulatory T cells （Tregs）, serum HBV-DNA and glutamate pyruvate aminotrans- ferase （ALT） in peripheral blood were compared. Results There were no significant differences in the proportion of CD4＋ CD25＋ regulatory T cells, ALT content and HBV-DNA content between complete response group, partial response group and non response group before treatment（P〉0.05）, but they were significantly higher than those in hea!t,hy control group, there were statistically significant differences between the groups（P〈0.05）; The proportion of Tregs in the complete response group and the partial response group after treatment were significantly decreased compared with that before treatment （P〈0.05）; The proportion of Tregs in patients of complete response group and partial response group had been declining during the treatment and withdrawal; Tregs ratio in patients with HBV-DNA negative were gradually de-creased and were significantly lower than that of non negative patients during the treatment（P〈0.05）; Tregs proportion of seroconversion in converted patients during treatment were gradually declined and were significantly lower than non- converted patients （P〈0.05）. Conclusion The peripheral regulatory T cells in patients with chronic hepatitis B by inter- ferons antiviral treatment was decreased during treatment and after treatment, and the sooner the peripheral regulatory T cells declined the greater possibility of seroconversion after treatment.