HBeAg状态对HBV/TP重叠感染患者细胞免疫功能的分析

Analysis of cellular immune function in patients with HBV/TP superinfection with different HBeAg status

目的比较不同乙肝病毒e抗原(HBeAg)水平的HBV/TP重叠感染患者的细胞免疫功能,进一步了解HBV/TP重叠感染患者细胞免疫功能变化。方法回顾性分析2019年1月至2020年1月成都市双流区第一人民医院收治的79例HBV/TP重叠感染患者的临床及实验室资料,根据治疗前HBeAg不同状态分为两组,其中HBeAg阳性组41例,HBeAg阴性组38例。对比两组患者外周血HBV-DNA水平、T淋巴细胞亚群水平以及T细胞相关细胞因子水平。结果 HBeAg阳性组HBV-DNA水平明显高于HBeAg阴性组(P<0.05);HBeAg阳性组CD3^(+)T、CD4^(+)T淋巴细胞、CD4^(+)T/CD8^(+)T比值、自然杀伤(NK)细胞水平高于HBeAg阴性组(P<0.05),CD8^(+)T淋巴细胞水平低于HBeAg阴性组(P<0.05);HBeAg阳性组干扰素-γ(IFN-γ)、肿瘤坏死因子(TNF-α)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、白细胞介素-17(IL-17)、转化生长因子-β(TGF-β)水平明显高于HBeAg阴性组(P<0.05),HBeAg阳性组白细胞介素-4(IL-4)和白细胞介素-10(IL-10)水平与HBeAg阴性组对比无明显差异(P>0.05)。结论 HBeAg水平影响HBV/TP重叠感染患者的免疫功能,可能诱导机体启动细胞免疫,提高T淋巴细胞亚群水平,促进分泌相关细胞因子。

Objective To compare the cellular immune function of patients with hepatitis B virus/Treponema pallidum (HBV/TP) superinfection with different hepatitis B virus e antigen (HBeAg) status,and to further understand the changes of cellular immune function in patients with HBV/TP coinfection.Methods The clinical data of 79 patients with HBV/TP superinfection admitted to our hospital from January 2019 to January 2020 were retrospectively analyzed.All patients were divided into 2 groups according to the different HBeAg status before treatment,41 HBeAg-positive patients were included in the HBeAg-positive group,and 38 HBeAg-negative patients were included in the HBeAg-negative group.The levels of HBV-DNA,T cell-related cytokines and T lymphocyte subsets in the peripheral blood of the two groups were compared.Results The level of HBV-DNA in the HBeAg-positive group was substantially higher than that in the HBeAg-negative group (P<0.05).The levels of CD3^(+)T,CD4^(+)T,CD4^(+)T/CD8^(+)T and natural killer (NK) cells in the HBeAg-positive group were higher than those in the HBeAg-negative group (P<0.05),and the CD8^(+)T cell level was lower than that in the HBeAg-negative group (P<0.05).The levels of interferon-γ (IFN-γ),tumor necrosis factor (TNF-α),interleukin-2 (IL-2),interleukin-6 (IL-6),interleukin-17 (IL-17),transforming growth factor-β (TGF-β) in the HBeAg-positive group were substantially higher than those of the HBeAg-negative group (P<0.05).The levels of interleukin-4 (IL-4) and interleukin-10 (IL-10) in the HBeAg-positive group were not significantly different from those in the HBeAg-negative group (P>0.05).Conclusion HBeAg level affects the immune function of patients with HBV/TP coinfection,which may induce the body to start cellular immunity,improve the level of T lymphocyte subsets and promote the secretion of related cytokines.