慢性HBV感染者不同病理状态下外周血淋巴细胞亚群及HBV-DNA定量变化

Quantitative changes of peripheral blood lymphocyte subsets and HBV-DNA in patients with chronic HBV infection under different pathological conditions

目的:研究慢性乙肝患者肝脏不同病理状态下外周血T淋巴细胞亚群及HBV-DNA载量变化。方法:选取就诊的96例慢乙肝患者行肝穿刺病理活检,应用流式细胞仪检测外周血T细胞亚群数量,罗氏DNA检测血清HBV-DNA含量,数据进行统计学分析。结果:(1)慢性乙肝患者炎症程度≥G2组外周血CD4+T细胞高于<G2组(t=4. 380,P=0. 000),CD8+T细胞低于<G2组(t=3. 636,P=0. 000),treg细胞低于<G2组(t=3. 292,P=0. 001),spearman相关分析显示,CD4+T细胞与肝脏炎症程度成正相关(r=0. 417,P=0. 000),CD8+T细胞、treg细胞与肝脏炎症程度成负相关(r=-0. 347,P=0. 000; r=-0. 337,P=0. 001);(2)肝脏病理在G2S2以下组T细胞亚群结果显示G1S0组CD4+T细胞低于G2S0组(t=2. 119,P=0. 049),CD8+T细胞高于G2S0组(t=2. 470,P=0. 024); G1S1组CD8+T细胞低于G1S0组(t=2. 292,P=0. 038);(3)肝脏纤维化S≥2组血清HBV-DNA载量低于S <2组(t=4. 503,P=0. 000),spearman相关分析,肝脏纤维化程度与HBV-DNA载量成负相关(r=-0. 204,P=0. 002)。结论:CHB患者存在T淋巴细胞亚群失衡及细胞免疫功能紊乱,各淋巴细胞亚群及血清HBV-DNA载量与肝脏病理有明显相关性。

Objective： To study on the changes of T lymphocyte subsets and HBV-DNA load in peripheral blood of patients with chronic hepatitis B under different pathological conditions. Methods： A total of 96 patients with chronic hepatitis B （CHB） were selected for liver biopsy. The number of T lymphocyte subsets in peripheral blood was detected by flow cytometry, the serum HBV-DNA content was detected by Roche DNA, and the data were analyzed statistically. Results： （1） The percentage of CD4＋ T cells in the group of inflammation level ≥G2 was significantly higher than that in the 〈G2 group （ t =4.380 P =0.000）. The percentages of CD8 ＋T cells and treg cells in the group of inflammation level ≥G2 were significantly lower than those in the 〈G2 group （ t =3.636, P =0.000; t =3.292, P =0.001）. The Spearman correlation analysis showed that there was a positive correlation between CD4 ＋ T cells and the degree of liver inflammation （ r =0.417, P =0.000）. There was a negative correlation between the level of CD8 ＋T cells and treg cells and the degree of liver inflammation （ r =-0.347, P =0.000; r =-0.337, P =0.001）. （2） The hepatic pathology of T lymphocyte subsets in the group of 〈 G2S2 showed that the percentage of CD4 ＋T cells in G1S0 group was significantly lower than that in G2S0 group （ t =2.119, P =0.049）; the percentage of CD8 ＋T in G1S1 group was lower than that in G1S0 group （ t =2.292, P =0.038）. （3） The serum HBV-DNA load of liver fibrosis S ≥ 2 group was significantly lower than that of S〈2 group （ t =4.503, P =0.000）. The Spearman correlation analysis showed that there was a negative correlation between liver fibrosis degree and HBV-DNA load （ r =-0.204, P =0.002）. Conclusion： There is an imbalance of T lymphocyte subsets and cellular immune dysfunction in patients with CHB. Lymphocyte subsets and serum HBV-DNA load were significantly correlated with liver pathology.