非嗜肝病毒感染所致肝损伤患者的病因及免疫功能分析

Analysis of etiology and immune function of liver injured patients infected by non‐hepatotropic viral

目的 分析非嗜肝病毒感染所致肝损伤患者常见致病原因及其免疫功能的变化.方法 对95例非嗜肝病毒感染患者检测丙氨酸氨基转移酶（ALT）、门冬氨酸氨基转移酶（AST）等肝功能指标,并分析外周血淋巴细胞的形态及 T淋巴细胞亚群的变化.结果 非嗜肝病毒感染最常见的原因为EB病毒、水痘疱疹病毒、麻疹病毒、巨细胞病毒（CM V）和出血热病毒,其中以EB病毒感染造成的肝损伤最为严重.所有患者按肝损伤程度分组,ALT≥80 U/L的肝损伤患者的异型淋巴细胞比例显著高于ALT〈80 U/L的患者（P〈0.01）,而CD4/CD8比值却显著降低（P〈0.05）,其差异具有统计学意义.结论 非嗜肝病毒感染造成严重肝损伤的患者不仅存在淋巴细胞形态的改变,同时伴有细胞免疫功能的紊乱,这可能是非嗜肝病毒导致肝损伤的原因之一.

Objective To analyze the etiology and immune function in patients with liver injury caused by non-hepatotropic viral infection.Methods The liver function indexes of ALT and AST were detected and the changes of peripheral lymphocytes morphol-ogy and T lymphocyte subsets were analyzed in 95 patients with non-hepatotropic viral infection.Results The most common reason for non-hepatotropic viral infection were Epstein Barr virus,varicella zoster virus,measles virus,cytomegalovirus and hemorrhagic fever virus.Among these viruses,Epstein Barr virus caused the severest liver injury.All patients were grouped by the liver injury degree,it showed that the proportion of atypical lymphocyte in liver injury patients with ALT ≥80 U/L was significantly higher than that of patients with ALT 〈80 U/L（P〈0.01）.However,the ratio of CD4/CD8 showed significantly decreased（P〈0.05）. Conclusion There was not only the change of lymphocyte morphology but also the disorder of cellular immune function in severe liver injury patients with non-hepatotropic viral infection,which may be one of the causes of liver injury by non-hepatotropic viru-ses.