老年CHB患者PD-1、PD-L1表达情况及其与T淋巴细胞的相关性

The Expression of PD-1 and PD-L1 in Elderly CHB Patients and their Correlation with T Lymphocyte Function

【目的】探讨老年慢性乙型肝炎(CHB)患者外周血中程序性细胞死亡蛋白-1(PD-1)及其配体(PD-L1)表达情况及其与T淋巴细胞的相关性。【方法】选取2020年3月至2021年4月两院收治86例老年CHB患者(观察组),根据其病情严重程度将其分为轻度组(n=41)、中度组(n=32)、重度组(n=13)。所有患者均接受恩替卡韦治疗,依据治疗48周后是否获得完全应答分为获得组(n=39)、未获得组(n=47)。比较观察组和对照组PD-1、PD-L1水平及T淋巴细胞(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))。分析观察组PD-1、PD-L1水平与T淋巴细胞、病情严重程度相关性,采用受试者工作特征(ROC)曲线分析PD-1、PD-L1对完全应答的预测价值。【结果】与对照组比较,观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)降低,PD-1、PD-L1、CD8^(+)升高(P<0.05)。重度组、中度组、轻度组T细胞中PD-1、PD-L1水平呈降低趋势(P<0.05)。PD-1、PD-L1水平与CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)呈负相关,且与CD8^(+)、病情严重程度呈正相关(P<0.05)。获得组患者PD-1、PD-L1水平低于未获得组,差异有统计学意义(P<0.05)。ROC曲线结果显示,PD-1、PD-L1对老年CHB患者抗病毒治疗的临床疗效具有一定预测价值(P<0.05)。【结论】老年CHB患者T细胞中PD-1、PD-L1水平升高,且与T淋巴细胞功能密切相关,可间接评估CHB病情进展,且对患者的抗病毒疗效具有较高预测价值。

【Objective】To investigate the expression of Programmed cell death protein-1(PD-1)and its ligand(PD-L1)in the peripheral blood of elderly patients with chronic hepatitis B(CHB)and their correlation with T lymphocytes.【Methods】A total of 86 elderly CHB patients(observation group)admitted to two hospitals from March 2020 to April 2021 were selected and divided into mild group(n=41),moderate group(n=32),and severe group(n=13)based on their severity.All patients were treated with Entecavir,and were divided into the acquired group(n=39)and the non acquired group(n=47)according to whether they received complete response after 48 weeks of treatment.The levels of PD-1,PD-L1,and T lymphocytes(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))were compared between the observation group and the control group.We analyzed the correlation between the levels of PD-1 and PD-L1 in the study group and T lymphocytes,as well as the severity of the disease.ROC analysis was conducted to assess the predictive value of PD-1 and PD-L1 for complete response.【Results】Compared with the control group,the observation group showed a decrease in CD3^(+),CD4^(+),CD4^(+)/CD8^(+),while PD-1,PD-L1,and CD8^(+)increased(P<0.05).The levels of PD-1 and PD-L1 in T cells of the severe,moderate,and mild groups showed a decreasing trend(P<0.05).The levels of PD-1 and PD-L1 were negatively correlated with CD3^(+),CD4^(+),CD4^(+)/CD8^(+),and positively correlated with CD8^(+)and disease severity(P<0.05).The levels of PD-1 and PD-L1 in the acquired group were lower than those in the non acquired group,and the difference was statistically significant(P<0.05).The results of Receiver operating characteristic showed that PD-1 and PD-L1 had a certain predictive value for the clinical efficacy of antiviral therapy in elderly CHB patients(P<0.05).【Conclusion】The levels of PD-1 and PD-L1 in T cells of elderly CHB patients are elevated and closely related to T lymphocyte function,which can indirectly evaluate the progression of CHB and have high predictive value for the antiviral efficacy of patients.