慢性乙肝患者外周血PBMC凋亡相关因子和Th1/Th2型细胞因子的水平变化及意义

The level and significance of PBMC apoptosis related factors and Th1/Th2 type cytokines in peripheral blood of patients with chronic hepatitis B

目的探讨慢性乙型肝炎患者外周血单个核细胞(PBMC)凋亡相关因子和Th1/Th2型细胞因子水平变化及意义。方法前瞻性选取2017年1月至2017年12月在航空工业三六三医院治疗的慢性乙型肝炎患者102例,其中轻度32例,中度40例,重度30例,健康志愿者40例作为对照组。检测含半胱氨酸的天冬氨酸蛋白水解酶-9(Caspase-9)、Caspase-8、Caspase-3、白细胞介素-2(IL-2)、IL-4、IL-10和干扰素-γ(IFN-γ)水平。记录慢性乙型肝炎患者HBVDNA定量检测结果,分析HBVDNA与各指标相关性。结果轻度组、中度组和重度组Caspase-9、Caspase-8和Caspase-3水平明显高于对照组(P<0.05),其中轻度组Caspase-9、Caspase-8和Caspase-3明显高于中度组和重度组(P<0.05);轻度组、中度组和重度组IL-2和IFN-γ水平明显低于对照组(P<0.05),而IL-4和IL-10明显高于对照组(P<0.05),其中轻度组IL-2和IFN-γ也明显高于中度组和重度组(P<0.05),而IL-4和IL-10则明显低于中度组和重度组(P<0.05);病毒载量与Caspase-9、Caspase-8、Caspase-3、IL-2和IFN-γ呈正相关(r=0.370,r=0.364,r=0.355,r=0.341和r=0.360,P<0.05),与IL-4、IL-10呈负相关(r=-0.411,r=-0.403,P<0.05)。结论慢性乙肝患者外周血PBMC凋亡增强,Th1/Th2免疫调节紊乱,可能在疾病发生发展中起一定作用,且与病毒载量有一定相关性。

Objective To investigate the level and significance of peripheral blood mononuclear cells (PBMC) apoptosis related factors and Th1/Th2 type cytokines in patients with chronic hepatitis B. Methods A prospective study was conducted,102 cases of chronic hepatitis B treated in our hospital from January 2017 to December 2017 were selected,including 32 mild patients,40 moderate patients,30 severe patients,and 40 healthy volunteers as control group,the cysteine containing aspartate protein hydrolase -9 (Caspase-9),Caspase-8,Caspase-3,interleukin -2 (IL-2),IL-4,IL-10 and interferon (IFN-γ) were detected. Results The Caspase-9,Caspase-8 and Caspase-3 in mild group,moderate group and severe group were significantly higher than those in the control group ( P <0.05),the Caspase-9,Caspase-8 and Caspase-3 in mild group were significantly higher than those in moderate group and severe group ( P <0.05);The IL-2 and IFN-γ in mild group,moderate group and severe group were significantly lower than those in the control group ( P <0.05),while IL-4 and IL-10 were significantly higher than those in control group ( P <0.05),the IL-2 and IFN-γ in mild group were significantly higher than those in moderate group and severe group ( P <0.05), while IL-4 and IL-10 were significantly lower than those in moderate group and severe group ( P <0.05);The viral load was positively correlated with Caspase-9,Caspase-8,Caspase-3,IL-2 and IFN-( r =0.370, r =0.364, r =0.355, r =0.341 and r =0.360, P <0.05),was negative correlated with IL-4 and IL-10 ( r =-0.411, r =-0.403, P <0.05). Conclusion The apoptosis of PBMC in peripheral blood of patients with chronic hepatitis B are increased,and the immune regulation of Th1/Th2 is disturbed,which may play a role in the development of disease,and has a certain correlation with the viral load.