不同基因型慢性乙型肝炎患者外周血辅助性T细胞分化和树突状细胞的功能  

The function of Th and dendritic cells in patients with different hepatitis B virus genotypes

作　　者：王凯[1] 卢芩[2] 韩利岩[1] 王兵[1] 林亚杰[1] 

机构地区：[1]山东大学齐鲁医院肝病科,济南250012 [2]东南大学附属中大医院消化科

出　　处：《中华传染病杂志》2005年第3期161-165,共5页Chinese Journal of Infectious Diseases

摘　　要：目的探讨不同基因型的慢性乙型肝炎(乙肝)患者体内辅助性T细胞(Th)和树突状细胞(DCs)功能差别。方法检测29例不同基因型慢性乙肝患者外周血Th细胞因子(IL-12、IL-2、IL-4)的表达,并对其中20例不同基因型患者进行外周血DC的分离和体外诱导培养,观测其形态和数量变化,检测DC分泌的IL-12含量,对数据应用t检验进行统计学分析。结果慢性乙肝患者与正常对照组比较,外周血IL-12、IL-2、IL-4表达明显升高(t=2.9272,P<0.01;P<0.01;P<0.05)。C型患者组与D型患者组比较,丙氨酸转氨酶(ALT)、IL-12、IL-2、Th1/Th2明显升高(t=2.4626,P<0.05;P<0.05;P<0.05;P<0.01),IL-4明显降低(P<0.05)。慢性乙肝患者外周血的单核细胞经培养和细胞因子诱导后,可获得成熟的具有典型形态的DC。慢性乙肝患者组与正常对照组比较,DC数量明显减少(t=5.4186,P<0.01),DC分泌的IL-12水平明显降低(t=3.265,P<0.01)。不同基因型患者之间DC的数量与DC分泌IL-12差异无统计学意义。结论慢性乙肝患者体内存在Th分化的不平衡;C型慢性乙肝患者体内Th1优势应答,肝脏炎症较重,治疗效果及预后较差。Objective To study the function difference of T helper cells（Th）and dendritic cells （DCs） in patients with different hepatitis B virus （HBV） genotypes. Methods IL-12,IL-2 and IL-4 released by Th was measured in 30 patients with different HBV genotypes. After DCs were differentiated and proliferated, DCs＇ configuration and amounts were observed, and IL-12 released by DCs was measured in 20 patients. Then the data were statistical analyzed. Results IL-12, IL-2 and IL-4 were significantly higher in patients with hepatitis B than the controls （t=2. 9272 ,t= 2. 7350, P〈0.01 ;t= 2. 7350,P〈0.01;t=2. 6028,P〈0.05）. ALT, IL-12, IL-2 and Th1/Th2 were significantly higher （t =2.4626,P〈0. 05; t=2. 3204,P〈0.05; t=2. 3778,P〈0.05; t=2. 8438,P〈0.01） and 1174 was significantly lower（t=2. 9574,P〈0.05） in patients with genotype C than patients with genotype D. After peripheral blood mononuclear cells （PBMC） were isolated and incubated, DCs with representative shape were achieved. The amount of DCs was significantly lower（t=5. 4186,P〈0.01） and IL-12 released by DCs was significantly lower（t= 3. 2650, P〈0.01 ）in patients with hepatitis B than controls. The amount of DCs and IL-12 released by DCs had no significantly changes in patients with different HBV genotypes. Conclusions There was an imbalance of Th polarization in patients with hepatitis B. In patients with genotype C, Thl was in the ascendant, so hepatic inflammation was severe and curative effect and prognosis would be bad.

关 键 词：肝炎 乙型 慢性 T淋巴细胞 辅助诱导 基因型 树突细胞 肝炎病毒 乙型 外周血IL-12 慢性乙型肝炎患者 不同基因型 树突状细胞 T细胞分化 

分 类 号：R512.62[医药卫生—内科学] R373.21[医药卫生—临床医学]