儿童和青少年自身免疫性肝炎患者外周血淋巴细胞亚群变化及其临床意义探讨

Changes of CD4+and CD8+T cells in peripheral blood in children and adolescents with autoimmune hepatitis

目的研究儿童和青少年AIH患者外周血淋巴细胞亚群的变化及其临床意义。方法2015年6月~2019年1月我院收治的儿童和青少年AIH患者42例和健康儿童和青少年50例,使用流式细胞仪检测外周血单个核细胞表面标志物。结果AIH患者外周血CD4+T细胞百分比为53.1(42.5,57.8)%,显著高于健康人[43.7(39.2,46.6)%,P<0.05],而CD14+T细胞百分比为62.2(40.1,76.8)%,显著低于健康人[83.7(74.2,90.2)%,P<0.05],而两组外周血CD8+T细胞百分比无显著性差异【25.9(12.5,32.4)%对18.7(12.8,28.5)%,P>0.05);AIH患者外周血CD4+T淋巴细胞表面CD45RA、CD45RO、CCR3和CD28表达百分比分别为26.1(15.2,32.8)%、19.2(13.5,27.3)%、15.4(2.1,53.8)%和51.2(34.4,56.9)%,均显著高于健康人[分别为18.6(11.5,27.2)%、13.6(8.7,18.1)%、1.1(0.0,2.4)%和33.7(30.2,46.1)%,P<0.05];AIH患者外周血CD8+T淋巴细胞表面CD45RA、CCR3和CD25表达百分比分别为18.0(14.1,26.8)%、1.2(0.5,3.2)%和0.6(0.3,7.8)%,显著高于健康人【分别为13.6(8.2,18.3)%、0.5(0.3,0.6)%和0.3(0.2,0.5)%,P<0.05],而外周血CD8+T淋巴细胞表面CD45RO表达百分比为2.7(2.3,4.8)%,显著低于健康人[4.7(2.8,11.7)%,P<0.05];AIH患者外周血CD14+T淋巴细胞表面CD45R0表达百分比为34.7(16.3,57.8)%,显著低于健康人[82.1(73.2,89.7)%,P<0.05]。结论外周血CD4+、CD8+和CD14+T细胞比例失衡及其细胞表面分子表达异常与AIH患者发病或病情进展密切相关,值得进一步研究。

Objective The aim of this study was to investigate the change and its clinical significance of peripheral blood lymphocyte subsets in children and adolescents with autoimmune hepatitis(AIH).Methods 42 child and adolescent patients with AIH and 50 healthy children were recruited in our hospital from June 2015 through January 2019,and the peripheral blood mononuclear cell surface markers were detected by flow cytometry.Results The percentage of CD4+T cells in children with AIH was 53.1(42.5,57.8)%,significantly higher than[43.7(39.2,46.6)%,P<0.05],while that of CD14+T cells was 62.2(40.1,76.8)%,significantly lower than[83.7(74.2,90.2)%,P<0.05]in healthy children,and there was no significant difference in percentage of CD8+T cells between the two groups【25.9(12.5,32.4)%vs.18.7(12.8,28.5)%,P>0.05);the percentages of CD45RA,CD45RO,CCR3 and CD28 on the surfaces of CD4+T cells in AIH patients were 26.1(15.2,32.8)%,19.2(13.5,27.3)%,15.4(2.1,53.8)%and 51.2(34.4,56.9)%,all significantly higher than[18.6(11.5,27.2)%,13.6(8.7,18.1)%,1.1(0.0,2.4)%and 33.7(30.2,46.1)%,respectively,P<0.05]in healthy children;the percentages of CD45RA,CCR3 and CD25 on the surfaces of peripheral blood CD8+T cells were 18.0(14.1,26.8)%,1.2(0.5,3.2)%and 0.6(0.3,7.8)%,significantly higher than【13.6(8.2,18.3)%,0.5(0.3,0.6)%and 0.3(0.2,0.5)%,respectively,P<0.05],while that of CD45RO on the surface of CD8+T cells was 2.7(2.3,4.8)%,significantly lower than[4.7(2.8,11.7)%,P<0.05]in the control;the percentage of CD45R0 on the surface of CD14+T cells in children with AIH was 34.7(16.3,57.8)%,much lower than[82.1(73.2,89.7)%,P<0.05]in healthy children.Conclusion The imbalance of CD4+,CD8+and CD14+T cells in peripheral blood and the abnormal expression of cell surface molecules are closely related to the onset or progression of AIH in young patients and deserve further study.