抗病毒治疗对慢性乙型肝炎患者外周血HBV特异性细胞毒性T淋巴细胞的影响及其临床意义

Study the changes and clinical significance of peripheral blood specific cytotoxic T lymphocytes, in chronic hepatitis B patients underwent the antiviral therapy

目的:研究慢性乙型肝炎(CHB)患者抗病毒治疗前后外周血HBV特异性细胞毒性T淋巴细胞(CTL)的变化及其临床意义。方法:选择我院2016年7月至2018年1月纳入的90例CHB患者作为A组,51例非病毒性肝病患者作为B组,另选择同一时间体检的80例健康者作为C组,均检测其外周血HBV特异性CTL、HBV DNA、丙氨酸氨基转移酶(ALT)变化。结果:A组患者治疗后的HLA-A2^+检出率低于治疗前,但治疗前后的HLA-A2^+检出率均高于B、C组(P<0.05)。A组患者治疗前后的HBV特异性CTL阳性率与B、C组相比差异有统计学意义(P<0.05),其中HLA-A2^-组的阳性率高于HLA-A2^+组(P<0.05);但B、C组的HLA-A2^-组的阳性率与HLA-A2^+组差异无显著性(P>0.05)。A组治疗前后的HBV DNA、ALT水平与B、C组相比差异有显著性(P<0.05),除C组的HBV DNA水平之外,各组HLA-A2^-的水平与HLA-A2^+相比差异有显著性(P<0.05)。结论:慢性HBV感染患者治疗前后的外周血HBV特异性CTL存在较大差异,可为临床预后评估的指标。

Objective:To study the changes of peripheral blood specific cytotoxic T lymphocytes(CTL), in chronic hepatitis B CHB patients underwent the antiviral therapy.Methods:Ninety cases CHB patients treated from July 2016 to January 2018 in our hospital were selected as group A;51 non-viral liver disease patients were selected as group B;80 healthy checkups were selected as group C.The peripheral blood specific CTL, HBV DNA and alanine aminotransferase(ALT) were detected.Results:After treatment, the detection rate of HLA-A2^+ in group A was lower than before;before and after treatment, the detection rate of HLA-A2^+ in group A was higher than group B and group C(P<0.05);before and after treatment, the positive specific CTL rate in group A was significantly different from group B and group C(P<0.05);besides, the positive HLA-A2^- rate was higher than the HLA-A2^+ rate(P<0.05);the positive HLA-A2^- rate in group B and group C was not significantly different from the HLA-A2^+ rate(P>0.05);before and after treatment, the HBV DNA and ALT contents in group A were significantly different from group B and group C(P<0.05);except for HBV DNA contents in group C, the HLA-A2^- and HLA-A2^+ contents among groups were significantly different(P<0.05).Conclusion:Before and after treatment, the peripheral blood specific CTL of CHB patients was significantly different, which can be considered as the important indicators of clinical prognosis assessment.