乙型肝炎患者外周血T细胞亚群、IL-6及IL-8水平的表达及临床意义

Expression and Clinical Significance of T Cell Subsets,IL-6 and IL-8 Levels in Peripheral Blood of Patients with Hepatitis B

目的:探讨乙型肝炎患者外周血T细胞亚群、白细胞介素-6(IL-6)及白细胞介素-8(IL-8)水平的表达及临床意义。方法:选取2015年1月-2017年12月期间我院收治的乙型肝炎患者240例为研究对象。其中急性乙型肝炎患者55例(急性组),慢性乙型肝炎患者185例,并根据临床症状严重程度分为慢性轻度组65例、慢性中度组61例、慢性重度组59例。将乙型肝炎患者HBV-DNA载量>103copy/m L作为HBV-DNA阳性组(n=158),HBV-DNA载量≤103copy/m L作为HBV-DNA阴性组(n=82)。另选取同期于我院行健康体检的志愿者50例为对照组。比较各组研究对象CD3+、CD4+、CD8+、CD4+/CD8+、IL-6、IL-8水平,比较HBV-DNA阳性组、HBV-DNA阴性组患者血清丙氨酸转氨酶(ALT)、总胆红素(TB)以及白蛋白(ALB)水平。采用Pearson相关性分析乙型肝炎患者血清IL-6、IL-8与肝功能指标的相关性。结果:急性组、慢性轻度组、慢性中度组、慢性重度组的CD3+、CD4+、CD4+/CD8+水平均低于对照组,CD8+、IL-6、IL-8均高于对照组(P<0.05)。HBV-DNA阳性组与HBV-DNA阴性组CD3+、CD4+、CD8+、CD4+/CD8+、IL-6、IL-8、ALT、TB以及ALB比较差异无统计学意义(P>0.05)。Pearson相关性分析显示,乙型肝炎患者血清中IL-6、IL-8均与ALT、TB水平呈正相关,与ALB水平呈负相关(P<0.05)。结论:乙型肝炎患者CD3+、CD4+和CD4+/CD8+显著降低,CD8+、IL-6和IL-8显著升高,且血清中IL-6、IL-8水平可反映乙型肝炎患者肝细胞损害程度及病情严重程度。

Objective： To study the expression and clinical significance of T cell subsets, Interleukin-6（IL-6） and Interleukin-8（IL-8） levels in peripheral blood of patients with hepatitis B. Methods： A total of 240 patients with hepatitis B, who were treated in the421 th Hospital of PLA from January 2015 to December 2017, were selected as research subjects. Among the 240 patients, 55 were acute hepatitis B（acute group） and 185 were chronic hepatitis B（chronic group）. According to the severity of clinical symptoms, the patients in chronic group were again divided into chronic mild group（n= 65）, chronic moderate group（n=61） and chronic severe group（n=59）. The HBV-DNA of patients with hepatitis B load 103 copy/m L was taken as HBV-DNA positive group（n=158）, and HBV-DNA load ≤103 copy/ml was taken as HBV-DNA negative group（n=82）. In addition, 50 volunteers in the same period were selected as control group.CD3^＋, CD4^＋, CD8^＋, CD4^＋/CD8^＋, IL-6 and IL-8 levels in each group were compared. The serum alanine aminotransferase（ALT）, total bilirubin（TB） and albumin（ALB） levels were compared between the HBV-DNA positive group and the HBV-DNA negative group. The correlation of serum IL-6, IL-8 and liver function in the patients with hepatitis B were analysed by Pearson correlation analysis. Results：CD3^＋, CD4^＋and CD4^＋/CD8^＋levels of the acute group, the chronic mild group, the chronic moderate group and the chronic severe group were all lower than those of the control group,but CD8^＋, IL-6 and IL-8 levels were higher than those of the control group（P〈0.05）. There was no significant difference in the levels of CD3^＋, CD4^＋, CD8^＋, CD4^＋/CD8^＋, IL-6, IL-8, ALT, TB and ALB between HBV-DNA positive group and HBV-DNA negative group（P〈0.05）. Pearson correlation analysis showed that the serum levels of IL-6 and IL-8 in the patients with hepatitis B were positively correlated with ALT and TB level,negatively correlated with ALB level（P〈0.05）. Conclusion： The levels of CD3^＋, CD4^＋and CD4^＋/CD8^＋significantly decrease in the patients with hepatitis B,and the levels of CD8^＋, IL-6 and IL-8 significantly increase. The levels of IL-6 and IL-8 in the serum can reflect the degree of liver cell damage and severity of hepatitis B patients.