病毒性肝炎T细胞亚群和几种细胞因子变化的研究  

A study on T lymphocyte subests and several cytokines in children with viral hepatitis

作　　者：崔雯[1] 董永绥[1] 方峰[1] 李革[1] 

机构地区：[1]同济医科大学附属同济医院儿科

出　　处：《中华儿科杂志》1997年第12期641-644,共4页Chinese Journal of Pediatrics

摘　　要：为了探讨小儿病毒性肝炎发病的细胞免疫机制，应用不标记抗体桥联酶标技术（ＡＰＡＡＰ法）检测了５６例病毒性肝炎患儿的外周血Ｔ细胞亚群及膜性白细胞介素２受体（ｍＩＬ－２Ｒ）表达率。应用酶联免疫吸附（ＥＬＩＳＡ）法分别检测了４９例病毒性肝炎患儿单个核细胞培养上清液（ＰＢＭＣｓ）中肿瘤坏死因子α（ＴＮＦα）、白细胞介素６和８（ＩＬ－６、ＩＬ－８）及α干扰素（ＩＦＮ－α）浓度。结果显示：甲型肝炎（简称甲肝）急性期、慢性乙型肝炎（简称乙肝）及丙型肝炎（简称丙肝）组与正常对照比较，ＣＤ４细胞降低，ＣＤ８细胞升高。用植物血凝素（ＰＨＡ）刺激前，甲肝急性期患儿ｍＩＬ－２Ｒ表达率明显高于其他各组，用ＰＨＡ刺激后，各组ｍＩＬ－２Ｒ表达率均显著高于刺激前，但乙肝及丙肝组ｍＩＬ－２Ｒ表达率与正常对照比较则明显降低。甲肝急性期、乙肝及丙肝患儿ＰＢＭＣｓＴＮＦα、ＩＬ－６、ＩＬ－８均较正常对照组升高，而α干扰素（ＩＦＮ－α）均较正常对照组降低。甲肝恢复期ＣＤ４、ＣＤ８和ＰＨＡ刺激前ＰＢＭＣ上ｍＩＬ－２Ｒ表达率以及上述各细胞因子水平均恢复正常。提示细胞免疫功能紊乱与小儿病毒性肝炎的发病及肝损害过程有关。To investigate the cellular immunological changes in children with viral hepatitis. The authors determined T lymphocyte subsets and the expression rate of membranous IL2 receptor (mIL2R) of lymphocytes in peripheral blood in 56 cases (Hepatitis A 17, chronic hepatitis B 28 and hepatitis C 11) by using an alkaline phosphotase antialkaline phosphatase method. The levels of interleukin 6 and 8, interferon α and tumor necrosis factor α (IL6, IL8, IFNα, TNFα) in supernatant of cuitured peripheral blood mononuclear cells (PBMCs) of 49 cases (17, 21 and 11 cases with hepatitis A, B and C respectively) were measured. The results showed that the subproportion of CD4 was lower and CD8 higher in 3 viral hepatitis groups than that in normal control. Before stimulation with PHA, the rate of expression of mIL2R in acute stage of hepatitis A was significantly higher than those of the other groups. After stimulation with PHA, the rate of expression of mIL2R significantly increased in all groups compared to the prestimulation level. However, the rate of mIL2R expression in hepatitis B and C groups was lower than that in normal control. No significant difference was found among the groups of normal control, acute and recovery stage of hepatitis A. The levels of IL6, IL8, TNFα in PBMCs of all the 3 viral hepatitis groups increased and the level of INFα decreased as compared with those of normal control. But there was no significant difference among the 3 viral hepatitis groups. It was concluded that cellular immunological disorders were related to the onset and induced damage of the viral hepatitis in children.

关 键 词：肝炎 病毒性肝炎 T淋巴细胞亚群 白细胞介素2 

分 类 号：R512.602[医药卫生—内科学]