重型肝炎患者淋巴细胞亚群的变化及其意义  

The changes and significance of T-lymphocytes subsets in severe hepatitis patients.

作　　者：高洪波[1] 许敏[1] 胡肖兵[1] 李粤平[1] 

机构地区：[1]广州市第八人民医院重症肝病区,广东广州510060

出　　处：《临床肝胆病杂志》2006年第3期175-176,共2页Journal of Clinical Hepatology

摘　　要：为了解重型肝炎(SH)患者T淋巴细胞亚群的变化及对疾病的预后的影响。对我院收治的46例重型肝炎病例(死亡组29例,存活组17例)与40例慢乙肝(CHB)的抗凝血,通过流式细胞仪检测其T淋巴细胞亚群,并与临床预后进行比较。结果:SH T淋巴细胞亚群计数CD3+、CD4+CD8-、CD4-CD8+细胞明显低于CHB组(P<0.05),可检测到大量幼稚的CD4+CD8+双阳细胞且其计数明显高于慢乙肝组(P<0.001),SH死亡组CD3+细胞明显低于存活组(P=0.04),CD4+CD8+双阳细胞明显高于存活组(P=0.005)。存活组随着病程恢复,CD3+、CD4+CD8-、CD4-CD8+细胞缓慢上升,死亡组持续低水平;存活组病程恢复时CD4+CD8+细胞逐渐下降,但死亡组反而上升。结论:T淋巴细胞亚群的变化特别是CD4+CD8+细胞的上升对预后判断有重要参考价值。To study the changing of whole blood T - lymphocytes subsets in severe hepatitis patients and its effect on the prognosis. 46 patients severe hepatitis of （ including 17 dead cases and 29 surviving cases who had been hospitalized from July, 2002 to December, 2004） and 40 chronic hepatitis B patients＇T- lymphocytes subsets were detected by flow cytometry. From the changes of T lymphocytes subsets we compared their related clinical prognosis of each case. Results ： The average CD3^＋ , CD4^＋ CD8^-, CD4^- CD8 ^＋ lymphocytes counts in severe hepatitis group were lower than chronic hepatitis controis groups There could be detected a lot of puerile CD4^＋ CD8^＋ lymphocytes in severe hepatitis group, whose counts were higher than chronic hepatitis group, The counts of CD3 ^＋ lymphocyte in severe hepatitis dead group were lowe than recover group, The count of CD4^＋ CD8^＋ lymphocytes in death groups were higher than that of recover groups. （ P = 0. 005 ）. The CD3^＋ , CD4^＋ CD8^＋ , CD4^- CD8^＋ lymphocytes was gradually increasing in severe hepatitis surviving group with the progress of clinical recovering while remained in low level in dead group for long. The CD4^＋ CD8^＋ lymphocytes was gradually deceasing in severe hepatitis surviving group with the progress of clinical recovering while was increasing in severe hepatitis dead group. Conclusion ： The changes of T - lymphocytes subsets especially the elevation of counts of CD4^＋ CD8^＋ lymphocytes may be one important marker to predict the clinical prognosis.

关 键 词：重型肝炎 T淋巴细胞亚群 CD4^+CD8^+ 抗原 

分 类 号：R512.62[医药卫生—内科学]