国人慢性HBV携带者HBV复制水平与T细胞亚群变化的关系  

Relationship between variations in peripheral T-lymphocyte subsets and viral replication levels in Chinese chronic HBV carriers with normal liver function tests

作　　者：游晶 庄林[2] 陈红英[3] 台虹[4] 宋建新[4] 欧阳红梅[4] 唐宝璋[3] Hutcha Sriplung Virasakdi Chongsuvivatwong Alan Geater 张一凤[3] 杨海秋[3] 黄俊华[5] 

机构地区：[1]Epidemiology Unit,Faculty of Medicine,Prince of Songkla University [2]昆明市第三人民医院肝病科,云南省昆明市650041 [3]昆明医学院第一附属医院感染病科,云南省昆明市650032 [4]云南省临床检验中心云南省第一人民医院,云南省昆明市650032 [5]中国人民武装警察部队云南总医院感染病科,云南省昆明市650111

出　　处：《世界华人消化杂志》2007年第35期3722-3727,共6页World Chinese Journal of Digestology

摘　　要：目的:研究慢性HBV携带者(HBVc)HBV复制水平与T细胞亚群变化的关系.方法:应用流式细胞仪检测肝功能正常的HBvc 216例和正常人100例外周血T细胞亚群百分比,ELISA法检测血清乙肝标志物(HBsAg,HBsAb,HBeAg,HBeAb,HBcAb,Anti-HBcAb IgM),实时荧光定量PCR法检测血清HBV DNA,对T细胞亚群结果与血清HBV DNA载量和HBeAg表达的关系进行分析.结果:HBV c外周血CD3^+,CD4^+及CD4^+/ CD8^+较正常人显著降低(P<0.01),而CD8^+显著升高(P<0.01).与HBV DNA(-)组比较,HBV DNA(+)组CD3^+,CD4^+及CD4^+/CD8^+分别降低20.4%,17.8%和35.7%,CD8^+升高21.9%(P<0.0 1).与HBeAg(-)组比较,HBeAg(+)组CD3^+,CD4^+及CD4^+/CD8^+分别降低19.5%,14.0%和28.6%,CD8^+升高19.6%(P<0.01).随着病毒载量的升高,CD3^+,CD4^+及CD4^+/CD8^+显著下降,分别与病毒载量呈显著负相关(r=-0.67,-0.54,-0.67,P<0.01);CD8^+显著升高,与病毒载量呈显著正相关(r=0.61,P<0.01).HBV DNA(+)和HBeAg(+)组与HBV DNA单阳性组和阴性组比较,CD3^+,CD4^+及CD4^+/CD8^+显著降低(P<0.05,P<0.01),CD8^+显著升高(P<0.01).有母亲感染史者CD3^+,CD4^+及CD4^+/CD8^+较无母亲感染史者明显降低,CD8^+则显著升高(P<0.01).在有母亲感染史者中,血清HBV DNA(+)82.2%,HBeAg(+) 75.2%,HBV DNA水平>1×10^(10)copies/L者65.1%,均分别显著高于无母亲感染史者的34.5%,OR=8.65,95%CI:[4.45,17.33],28.7%,OR=7.44,95%CI:[3.91,14.56]和10.3%,OR=15.94,95%CI:7.13,39.66].有母亲感染史和无母亲感染史者中,与HBV DNA(-)组比较,HBV DNA(+)组CD3^+,CD4^+及CD4^+/CD8^+均显著降低(P<0.05,P<0.01),CD8^+均显著升高(P<0.01);与HBeAg(-)组比较,HBeAg(+)组CD3^+,CD4^+及CD4^+/CD8^+比均显著降低(P<0.05,P<0.01).结论:肝功能正常的HBVc T细胞免疫功能紊乱与病毒复制水平之间存在显著相关性,HBV活跃复制进一步加重紊乱.AIM： To investigate the correlations between the variations in peripheral T-cell subpopulations and HBV replication levels in Chinese chronic HBV carriers （HBVc） with normal liver function tests. METHODS： The relative percentage of T-cell subpopulations in peripheral blood was measured by flow cytometry in 216 HBVc and 100 normal controls. HBV markers were detected by ELISA. Serum viral load was measured by realtime RT-PCR. The relationship between HBV replication level and variations in peripheral T-cell subpopulations was analyzed. RESULTS： HBVc had a decreased number of CD3^＋ and CD4^＋ cells, a decreased CD4^＋/CD8^＋ ratio, and an increased number of CD8^＋ cells compared.with normal controls （P 〈 0.01）. The levels of CD3^＋ and CD4^＋ cells and the CD4^＋/CD8^＋ ratio decreased 20.4%, 17.8% and 35.7%, respectively （P 〈 0.01）, and there was a 21.9% increase in the level of CD8^＋ cells in HBV DNA （＋） HBVc as compared with HBV DNA（-） HBVc （P 〈 0.01）. The level of HBeAg（＋） HBVc decreased 19.5%, 14.0% and 28.6% in CD3^＋ and CD4^＋ cells and CD4^＋/CD8^＋ ratio, respectively （P 〈 0.01）, and over 19.6% in CD8^＋ cells, compared with HBeAg （-） HBVc （P 〈 0.01）. There were negative correlations between the levels of CD3^＋ and CD4^＋ cells and the CD4^＋/CD8^＋ ratio and viral load （r = -0.67, -0.54, -0.67, P 〈 0.01）, and a positive correlation between the level of CD8^＋ cells and viral load （r = 0.61, P 〈 0.01）. Compared with the HBV DNA （＋） and HBV DNA（-） groups, the number of CD3^＋ and CD4^＋ cells and the CD4^＋/CD8^＋ ratio were significant lower, and the number of CD8^＋ cells was significant higher in the HBV DNA （＋）/HBeAg （＋） group. A similar pattern was seen in HBVc with maternal HBV- infection （MH） status compared with non-MH HBVc （P 〈 0.01）. The percentages of MH HBVc that were HBV DNA （＋） and HBeAg （＋）, and the number with a viral load 〉 1 ×10^10 copies/L,

关 键 词：慢性HBV携带者 HBV DNA T淋巴细胞 免疫功能 实时荧光定量PCR 

分 类 号：R512.6[医药卫生—内科学]