慢性乙型肝炎T细胞功能与HBV前C区变异的研究  

The Relationship between Function of T Cells Function and Pre-C Mutation in Chronic Hepatitis B Patients

作　　者：林雪松 徐逢敏 

机构地区：[1]大连市第六人民医院,辽宁大连116031

出　　处：《医学与哲学（B）》2011年第6期53-54,共2页Medicine & Philosophy(B)

摘　　要：通过研究慢性HBV感染者前C区变异及T细胞免疫功能与疾病的相关性,评估前C(pre C)区变异及T细胞免疫功能对于慢性乙型肝炎(chronic hepatitis B,CHB)预后的影响。分别采用实时荧光法、突变特异PCRmsPCR法及微粒酶免疫分析法对150例HBV-DNA阳性的CHB及50例健康体检者进行血清HBV-DNA、HBV-DNA pre C区变异及HBV血清免疫标志物检测,同时采用APAAP法对所有研究对象进行相关细胞免疫功能检测。在150例CHB中,HBVpre C1896变异检出率达26.6%(40/150),主要发生于慢性重度患者及抗HBe(+)患者。T细胞功能:CHB与正常对照组比较,外周血CD4明显下降,而CD8明显增高;在CHB组中,变异株组较野生株组CD4下降、CD8升高更明显。在CHB中存在细胞免疫功能紊乱,而HBV DNA pre C变异株组较野生株组更为严重,这些细胞免疫功能紊乱,与CHB的严重程度及其临床预后密切相关。To explore the effect of the function of cellular immunity and Pre--c mutation on the prognosis in patients with chronic hepatitis B. Total 150 cases of CHB patients were included in the study. Pre--c mutation was analyzed by msPCR. HBV--DNA levels were measured by real time PCR. The levels of CD4 and CD8 ＋ T cells were measured by APAAP method. The rate of Pre -- c mutation was 26. 6 % （ 40/150 ） in CHB patients. G1896A mutation was largely detected in HBeAg negative CHB patients. The levels of CD4 and ratios of CD4/CD8 were decreased significantly in both variant and wild-type patients, whereas CD8 was increased significantly, compared with those in control. The levels of CD4 and ratios of CD4/CD8 in variant group were lower than wild--type group, but the level of CD8 was higher in variant group. Our study suggested that presence of G1896A mutation may induce severe liver injury through activation of host immune.

关 键 词：慢性乙型肝炎 前C区变异 细胞免疫 CD4 CD8 

分 类 号：R512.62[医药卫生—内科学]