慢性乙型肝炎病毒感染患者外周血自然杀伤细胞和树突状细胞比例与肝损伤的关系

Relationship between proportions of peripheral natural kill cells and dendritic cells and liver injury in patients with chronic hepatitis B virus infection

目的·研究慢性乙型肝炎病毒(HBV)感染患者外周血自然杀伤(NK)细胞和树突状细胞(DC)比例与肝损伤的关系。方法·采集65例不同类型慢性HBV感染患者和10例健康志愿者(HCs组)外周血,流式细胞术检测NK细胞及DC比例。根据患者HBV血清学指标包括丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TB)、直接胆红素(DB)水平,将65例患者分为无症状HBV携带者(As Cs)组(n=7)、慢性乙型肝炎轻-中度(CHB-LM)组(n=38)、慢性乙型肝炎重度(CSHB)组(n=20),进行组间比较,并分析NK细胞、DC及两者比例与肝损伤的关系。结果·组间比较外周血NK细胞比例,CHB-LM组[(9.29±1.20)%]和CSHB组[(3.60±0.79)%]低于HCs组[(14.77±2.90)%]和As Cs组[(14.05±2.32)%](均P=0.000)。外周血DC比较,CHB-LM组[(4.10±1.18)%]高于HCs组[(1.67±0.31)%]、As Cs组[(2.05±0.46)%]和CSHB组[(2.08±0.41)%](P=0.000)。NK/DC比值比较,CHB-LM组(2.77±1.67)和CSHB组(2.24±2.08)明显低于HCs组(10.11±4.24)和As Cs组(8.12±5.05)(均P=0.000)。相关性分析结果显示慢性HBV感染者NK细胞比例与ALT、AST、TB、DB水平呈负相关(r=-0.50,r=-0.49,r=-0.53,r=-0.51,均P=0.000)。结论·慢性乙型肝炎患者外周NK细胞比例和NK/DC比值降低,慢性HBV感染者外周NK细胞比例和NK/DC比值下降与肝损伤相关。

Objective · To investigate the correlation between proportion of natural killer （NK） cells and dendritic cells （DCs） and liver injury in patients with chronic hepatitis B virus （HBV） infection. Methods · Peripheral blood samples were collected from 65 patients with chronic HBV infection and 10 healthy volunteers （HCs group）. Flow cytometry was used to detect the proportion of peripheral NK cells and DCs. The patient were divided into asymptomatic HBV carrier （AsCs） group, chronic hepatitis B in low or moderate grade （CHB-LM） group, and chronic severe hepatitis B （CSHB）group. The relationship of the proportion of NK cells, the proportion of DCs, and the ratio of NK/DC with the degree of liver injury was analyzed. Results · The proportion of peripheral NK cells was significantly lower in CHB-LM group （9.29%±1.20%） and CSHB group （3.60%±0.79%） than that in HCs group （14.77%±2.90%） and AsCs group （14.05%±2.32%） （P=0.000）. And the proportion of peripheral DCs was significantly higher in CHB-LM group （4.10%±1.18%） than that in HCs （1.67%±0.31%）, AsCs （2.05%±0.46%） and CSHB groups （2.08%±0.41%） （P=0.000）. The ratio of NK/DC was decreased in CSHB and CHB-LM groups compared to that in HCs and AsCs groups （P=0.000）. The correlation analysis indicated the proportion of NK cells was negatively correlated with the levels of ALT, AST, TB and DB （r=-0.50, r=-0.49, r=-0.53, r=-0.51, P=0.000 for all） in patients with chronic HBV infection. Conclusion · The proportion of peripheral NK cells and the ratio of NK/DC in patients with chronic hepatitis B were decreased. The decrease of the frequency of NK cells and the ratio of NK/DC were associated with liver injury in patients with chronic HBV infection.