对低ALT水平慢性乙型肝炎人群的HBcrAg及CD4^(+)CD25^(+)调节性T细胞的相关性分析

Analysis of chronic hepatitis B disease progression with low ALT level by HBerAg expression level combined with CD4^(+)CD25^(+)regulatory T cells

目的探讨低ALT水平的慢性乙型肝炎患者外周血中乙型肝炎病毒核心相关抗原(HBcrAg)表达水平及与CD4^(+)CD25^(+)调节性T细胞之间的相关性,分析二者表达与疾病进展之间的关联性.方法收集我院收治的81例未接受抗病毒治疗的低ALT水平的慢性乙型肝炎患者,ELISA检测其血清中HBcrAg表达,流式细胞术检测CD4^(+)、CD4^(+)CD25^(+)、CD8^(+)T数量及比值.Spearman法对二者相关性进行分析.结果在HBeAg(^(+))与HBeAg(-)组,CD4^(+)占淋巴细胞总数之比、ALT、AST、HBsAg、HBVDNA有明显差异.HBeAg(^(+))的104IU/mL<HBVDNA<106IU/mL组中,HBcrAg与ALT呈正相关(r=0.800),与CD4^(+)CD25^(+)/CD4^(+)呈负相关(r=-0.400),CD4^(+)CD25^(+)/CD4^(+)与ALT呈负相关(r=-0.800);在HBeAg(-)的HBV DNA>106IU/mL组中,HBcrAg与ALT呈正相关(r=0.500),与CD4^(+)CD25^(+)/CD4^(+)呈负相关(r=-1.000),CD4^(+)CD25^(+)/CD4^(+)与ALT呈负相关(r=-0.500).结论高病毒载量的HBeAg(-)的低ALT水平慢性乙型肝炎患者中,HBcrAg与ALT存在正相关,与CD4^(+)CD25^(+)/CD4^(+)存在负相关.

Objective To study the correlation between HBerAg expression level and CD4^(+)CD25^(+)T cell/CD4^(+)T ratio in peripheral blood of patients with chronic hepatitis B with low ALT level,and to predict the progression of the disease.Methods Eighty-one patients with low ALT level in our hospital without antiviral therapy were ollected.The expression of HBcrAg in serum was detected by ELISA and the number and ratio of CD4^(+),CD4^(+)CD25^(+)and CD8^(+)cells were detected by flow cytome-try.The correlation between them was analyzed by Spearman method,and the state progress of chronic hepatitis B by HBerAg was predicted and analyzed by logistic method.Results There were significant differences in the ratio of CD4^(+)to the total num-ber of lymphocytes,ALT,AST,HBsAg and HBV DNA between HBeAg(^(+))and HBcAg(-)groups.In HBeAg(^(+))104 IU/mL<HBV DNA<10^(+)IU/mL group,HBcrAg was positively correlated with ALT(r=0.800),negatively correlated with CD4^(+)CD25^(+)/CD4^(+)(r=0.400),CD4^(+)CD25^(+)/CD4^(+)was negatively correlated with ALT(r=0.800),HBcrAg was positively correlated with ALT(r-0.500),ngatively correlated with CD4^(+)CD25^(+)/CD4^(+)(r=1.000)。CD4^(+)CD25^(+)/CD4^(+)was negatively correlated with ALT(r=0.500)in HBV DNA>106 IU/mL group of HBeAg(-).Conclusion In patients with chronic hepatitis B with high viral load and low ALT levels of HBeAg(-),HBcrAg was positively correlated with ALT and negatively correlated with CD4^(+)CD25^(+)/CD4^(+).