慢性乙型肝炎患者外周血CD4^+CD25^+调节性T细胞数量与肝脏疾病慢性化进展关系的研究  

Association between CD4^+CD25^+Regulatory T Cells in Peripheral Blood of Patients with HBV DNA Resolved Chronic Hepatitis B and Different Chronic Liver Process After Treated with NAs

作　　者：程瑗[1] 金晓芝[1] 叶超[1] 陈永平[1] 章圣辉[2] 洪炜龙[3] 谷甸娜[1] 张磊[1] 郑明华[1] 

机构地区：[1]温州医学院附属第一医院感染内科,325000 [2]温州医学院附属第一医院内科实验室,325000 [3]温州医学院附属第一医院外科实验室,325000

出　　处：《医学研究杂志》2011年第7期50-55,共6页Journal of Medical Research

基　　金：浙江省自然科学基金资助项目(Y207464);浙江省科技厅新苗人才计划资助项目(2008R40G209002)

摘　　要：目的探讨慢性乙型肝炎患者(chornic hepatitis B,CHB)外周血中CD4+CD 25+调节性T细胞(regulatory T cells,Treg)的数量与肝脏慢性疾病进展的关系。方法流式细胞术检测抗病毒治疗后45例CHB患者(根据B超将其分为3组,其中B超提示肝脏无异常改变的单纯CHB组15例,提示慢性肝病改变的CHB慢性肝病组15例,提示肝硬化改变的CHB肝硬化组15例)与B超均提示肝脏无异常改变的15例慢性乙型肝炎病毒携带者(asymptomic HBV carriers,ASCs)以及15例健康成年人(normal control,NC)对照外周血中CD4+CD25+Treg的变化,并分析Treg与患者年龄,HBeAg定量,ALT、AST、TGF-β1水平的相关性。结果外周血中CD4+CD25+Treg占CD4+淋巴细胞的比例在抗病毒治疗后单纯CHB组为(4.03±1.36)%,与NC组(4.02±1.14)%相比差异无显著性(t=0.0223,P>0.05),与ASCs组(5.26±1.25)%相比显著减少(t=-2.2872,P<0.05);CHB慢性肝病组为(5.65±2.01)%,CHB肝硬化组为(5.32±1.47)%,与NC组、单纯CHB组比显著增高(t值分别为3.0351、3.0129、2.4269、2.4046,均P<0.05)与ASCs组相比差异无显著性(t值分别为0.7257、0.1174,均P>0.05);CHB慢性肝病、肝硬化组间相比差异无显著性(t=0.6083,P>0.05)。Treg的数量与年龄、AST、TGF-β1水平呈正相关(r分别为0.327、0.324、0.306,P分别为0.004、0.005、0.008)。结论 Treg在低水平AST时CHB患者外周血中的数量的增高对抗病毒治疗后的CHB患者更能反映其肝脏慢性损伤程度,Treg可能参与了慢性HBV感染后肝脏疾病慢性化进展的过程。Objective To investigate the association between the frequency of circulating CD4＋ CD25 ＋ regulatory T cells （Treg） inpatients of HBV DNA resolved chronic hepatitis B and different chronic liver disease process after treated with NAs. Methods Tregs in peripheral blood from 45 HBV resolved CHB patients including 15 CHB patients with no anomaly liver changes in B - mode ultrasound, 15 patients with chronic liver disease changes in B - mode ultrasound and 15 patients with liver cirrhosis in B - mode ultrasound were assayed. We also used 15 asymptomic HBV carriers （ASCs） with no anomaly liver changes in B - mode ultrasound and 15 healthy subjects as control. Tregs were quantitatively analyzed using flow cytometry. Clinical and laboratory data were collected for further analysis. Results CHB patients with chronic liver disease changes or liver cirrhosis presented a higher fraction of circulating Tregs （ 5.65 ± 2.01）% or （5.32±1.47）% than those of healthy controls （4.02±1.14）% andCI-IB patients （4.03 ±1.36）% （P〈0.05） and were similar to ASCs （5.26± 1.25 ） % （P 〉 0. 05 ）. There was correlation between the frequency of Treg and the quantity of age, AST and TGFβ（r= 0.327,0.324, 0.306, P 〈0.01）. Conclusion The obviously heightened frequency of CD4＋CD2＋ Treg in the patients with chronic liver disease changes or liver cirrhosis in CHB may could be a sign of chronic liver disease and may could indicate the damage degree in chronic liver disease after being infected HBV. The role of CD4＋ CD25 ＋ Treg in the liver chronic damage after chornic HBV being infected may need further investigations.

关 键 词：慢性乙型病毒性肝炎 肝硬化CD4+CD25+调节性T细胞 

分 类 号：R392.4[医药卫生—免疫学]