外周血T淋巴细胞亚群在慢性乙型肝炎患者中的表达及临床意义

Expression and Clinical Significance of T Lymphocyte Subsets in Peripheral Blood of Patients with Chronic Hepatitis B

目的探讨外周血T淋巴细胞亚群在慢性乙型肝炎患者中的表达及临床意义。方法选取我院2017年3月-2018年5月收治慢性乙型肝炎患者86例为研究对象,同时选取健康体检者35例为对照组。对2组进行外周血T淋巴细胞亚群检测,测定比较86例患者血清中HBV DNA的含量与载量水平。结果慢性乙型肝炎组CD3^+、CD4^+、CD4^+/CD8^+比值均低于对照组,CD8^+高于对照组(P<0.01)。HBV DNA阳性组CD4^+/CD8^+、CD3^+、CD4^+低于HBV DNA阴性组,CD8^+高于HBV DNA阴性组(P<0.05)。低拷贝组CD3^+、CD4^+、CD4^+/CD8^+高于高拷贝组(P<0.05),低拷贝与高拷贝组CD8^+水平比较差异无统计学意义(P>0.05)。CD3^+、CD4^+随着病毒载量增加逐渐减少,CD8^+逐渐升高,CD4^+/CD8^+逐渐降低(P<0.05)。结论慢性乙型肝炎的患者在感染乙型肝炎病毒后会出现免疫功能下降,可通过对T淋巴细胞亚群的检测对免疫功能进行监测。

Objective To investigate expression and clinical significance of T lymphocyte subsets in peripheral blood of patients with chronic hepatitis B. Methods A total of 86 patients with chronic hepatitis B admitted during March 2017 and May 2018 were recruited in this study, and other 35 health people taking physical examinations were selected as control group. Levels of T lymphocyte subsets in peripheral blood were detected in both groups, and contents of HBV and DNA and load levels in serum of 86 patients were detected and compared. Results In chronic hepatitis B group, levels of CD3^+, CD4^+ and CD4^+/CD8^+ ratio were significantly lower, while CD8^+ level was significantly higher than those in control group(P<0.01). In hepatitis b virus(HBV) DNA positive group, levels of CD4^+/CD8^+, CD3^+ and CD4^+ were significantly lower, while CD8^+ level was significantly higher than those in HBV DNA negative group(P<0.05). Levels of CD3^+, CD4^+ and CD4^+/CD8^+ in low copy group were significantly higher than those in high copy group(P<0.05). There was no significant difference in CD8^+ level between low and high copy groups(P>0.05). With increasing viral load, CD3 ^+ and CD4^+ levels were gradually decreased, while CD8 ^+ level was gradually increased, and CD4^+/CD8^+ level was gradually decreased(P<0.05). Conclusion Patients with chronic hepatitis B may have decreasing immune function after infection with HBV, and immune function can be monitored by detecting T lymphocyte subsets.