慢性乙型肝炎患者外周血淋巴细胞凋亡的意义

THE IMPLICATION OF PERIPHERAL BLOOD LYMPHOCYTES APOPTOSIS IN PATIENTS WITH CHRONIC HEPATITIS B

目的 :探讨乙型肝炎患者外周血淋巴细胞 (peripheralbloodlymphocytes,PBLs)凋亡在其慢性化、重型化过程中的作用。方法 :分离 2 0例正常人、2 4例慢性乙型肝炎患者及 2 4例慢性重型乙型肝炎患者之PBLs ,体外单独或与植物血凝素 (PHA)共同培养 4 8h ,用荧光素吖啶橙和溴乙啶染色PBLs,观察其凋亡细胞百分率。结果 :慢性乙型肝炎患者与正常对照组静息的淋巴细胞凋亡率都比较低 ,两组比较差异无显著性 (P >0 .0 5 ) ;但与正常对照组相比 ,活化诱导的淋巴细胞凋亡在慢性乙型肝炎患者明显增高 ,而在慢性重型肝炎患者则降低 ,差异有显著性 (P <0 .0 1)。结论 :慢性乙型肝炎患者外周血淋巴细胞存在凋亡紊乱现象 ,这可能是导致乙型肝炎慢性化、重型化的重要因素之一。

Objective:To explore the immunopathogenesis of chronic hepatitis B by investigating the apoptosis of peripheral blood lymphocytes (PBLs). Methods:The PBLs of 20 normal controls. 24 patients with chronic hepatitis B and 24patients with chronic severe hepatitis B were isolated and cultured with or without phytohemagglutinin(PHA,10μg/ml) for 48 hours in vitro. After incubation, the cells were harvested by centrifugation and the apoptosis of PBLs was studied by staining with fluorescent dyes acridine-ethidum (AO+EB). Results:The apoptotic ratio of resting PBLs in the three investigated groups was at low levels, there was no significant difference among them ( P >0.05);but it in creased obviously after PHA stimulation in vitro ( P <0.01) , In comparison with normal controls, the apoptosis of PBLs was significantly higher in patients with chronic hepatitis B ( P <0.01) and lower in patients with chronic severe hepatitis B ( P <0.01).Conclusion: AICD (activation induced cell death)of PBLs was found in patients with chronic hepatitis B, the disregulation of AICD in PBLs may play an important role in the pathogenesis of chronic hepatitis B.