Th17、Treg细胞频数在核苷类似物抗HBV过程中的动态变化

Dynamic change of Th17 and Treg cells frequency in nucleoside analogues anti-HBV treatment

目的:探讨辅助性T细胞17(T helper 17cells,Th17)及调节性T细胞(regulatory T cells,Treg)细胞频数在核苷类似物治疗慢性乙型肝炎患者过程中的动态变化。方法:选取30例乙型肝炎e抗原(hepatitis B e antigen,HBeAg)阳性的慢性乙型肝炎患者作为研究对象。所有患者均采用替比夫定治疗。分析所有患者治疗前及治疗第4、8、12、24、36、48周的Treg细胞、Th17细胞频数及Th17/Treg比值。比较治疗前后患者血清总胆红素(total bilirubin in serum,TBIL)、血清直接胆红素(direct bilirubin in serum,DBIL)、丙氨酸氨基转移酶(alanine transaminase,ALT)、天冬氨酸氨基转移酶(aspertate aminotransferase,AST)、乙型肝炎病毒DNA(hepatitis B virus DNA,HBV-DNA)、HBeAg水平,分析Treg、Th17细胞频数与TBIL、DBIL、ALT、AST、HBV-DNA、HBeAg的相关性。结果:替比夫定治疗后,Treg细胞频数先下降后上升,于治疗第8周时达最低水平;Th17细胞频数呈下降趋势;Th17/Treg比值呈下降趋势,于治疗第24、36、48周时趋于稳定。与治疗前相比,治疗后患者TBIL、DBIL、ALT、AST、HBV-DNA、HBeAg水平均显著下降,差异有统计学意义(P<0.05)。Treg细胞频数与HBV-DNA、HBeAg水平正相关(P<0.05);Th17细胞频数与TBIL、DBIL、ALT、AST水平正相关(P<0.05)。结论:核苷类似物治疗慢性乙型肝炎患者过程中,Treg、Th17细胞频数及Th17/Treg比值呈现动态变化,且与治疗后肝功能指标水平相关,为临床治疗及预后评估提供了依据。

Objective：To investigate dynamic change of T helper 17 cells （Th17） and regulatory T cells（Treg） frequency in hepatitis B e antigen （HBeAg ） positive chronic hepatitis B patients receiving nucleoside analogues treatment . Methods：A total of 30 chronic hepatitis B patients with positive HBeAg were enrolled .All the patients received telbivudine antiviral treatment .The peripheral blood Treg cell frequency ,Th17 cell frequency and Th17/Treg ratio were detected before treatment and at 4th ,8th ,12th ,24th ,36th ,48th weeks after treatment .The total bilirubin in serum （TBIL） ,direct bilirubin in serum （DBIL ） ,alanine transaminase （ALT ） ,aspertate aminotransferase （AST ） ,hepatitis B virus DNA （HBV‐DNA ） and HBeAg level were detected and compared between before and after treatment .The correlations of Treg cell frequency and Th17 cell frequency with the indexes of TBIL ,DBIL ,ALT ,AST ,HBV‐DNA ,HBeAg were analyzed ,respectively .Results：Treg cell frequency was decreased then increased and reached the minimum point at 8th weeks after treatment .Th17 cell frequency decreased during treatment ;and Th17/Treg ratio decreased and was stable at 24th ,36th ,48th week after treatment .The levels of TBIL ,DBIL ,ALT ,AST ,HBV‐DNA and HBeAg were significantly decreased after treatment （P〈 0 .05） .Treg cell frequency was positively correlated with HBV‐DNA and HBeAg levels （ P〈 0 .05 ） . Th17 cell frequency was positively correlated with TBIL ,DBIL ,ALT and AST levels （P〈0 .05） .Conclusions：Treg cell frequency ,Th17 cell frequency and Th17/Treg ratio shows dynamic changes during nucleoside analogues treatment for HBeAg positive chronic hepatitis B patients .They are correlated with liver function indexes after treatment ;they can provide evidence for clinical treatment and prognosis evaluation .