乙型肝炎患者肝组织中乙型肝炎病毒抗原与CD8^+CD28^+ T细胞表达的关系及其临床意义  

The relationship between the expressions of HBV and CD8^+CD28^+ T lymphocyte in liver tissue of hepatitis B patients and its corresponding clinical significance

作　　者：涂远航[1] 荣梅生[2] 马勇[1] 

机构地区：[1]中国人民解放军第123医院传染科,安徽蚌埠233015 [2]蚌埠医学院医学检验系,安徽蚌埠233030

出　　处：《蚌埠医学院学报》2011年第12期1373-1376,1379,共5页Journal of Bengbu Medical College

摘　　要：目的:探讨乙型肝炎患者肝组织中乙型肝炎病毒(HBV)抗原与CD8+CD28+T细胞表达的关系及其临床意义。方法:应用免疫组织化学法和核酸原位杂交法检测轻、中、重度乙型肝炎肝组织中HBV抗原及核酸的表达,同时应用免疫组织化学法检测肝组织CD28T细胞表达并比较。结果:重度、中度、轻度乙型肝炎中HBsAg(+)HBcAg(+)、HBsAg(+)HBcAg(-)、HBsAg(-)HBcAg(+)和HBsAg(-)HBcAg(-)差异无统计学意义(P>0.05)。轻度乙型肝炎患者肝组织内CD8+CD28+T细胞水平较对照组低,中度和重度乙型肝炎患者CD8+CD28+T细胞和CD8+CD28-T细胞明显高于对照组(P<0.05),且CD8+CD28+T细胞随着炎症分级逐级升高,CD8+CD28-T细胞却随着炎症分级逐级减低(P<0.01)。HBsAg(+)HBcAg(+)中、重度慢性乙型肝炎患者,肝组织中CD8+CD28+T淋巴细胞表达低于HBsAg(+)HBcAg(-)、HBsAg(-)HBcAg(+)和HBsAg(-)HBcAg(-)慢性乙型肝炎患者的表达(P<0.05～P<0.01)。HBV DNA、HBeAg在不同分级炎症活度中表达差异均无统计学意义(P>0.05)。结论:肝组织HBV更能准确反映肝组织HBV DNA复制情况,是机体免疫状态的间接反映,可作为抗病毒治疗适应证选择及疗效预测因子。CD8+T淋巴细胞表面CD28分子的表达强度与HBV的清除密切相关,CD28高表达可促进肝细胞内HBV清除。Objective：To study the relationship between the expressions of hepatitis B virus （HBV） antigen and CD8＋CD28 ＋T lymphocyte in liver tissue of hepatitis B patients and analyze the corresponding clinical significance. Methods：The expressions of HBV antigens and nucleic acid were detected by immunohistoehemistry and situ hybridization method in each groups （mild, moderate and severe hepatitis B groups ）. The expression of CD28 T lymphocyte in liver tissue was determined by immunohistochemistry and the results of each group were compared. Results ： There was no significant difference in the expressions of HBsAg （ ＋ ） HBeAg （ ＋ ） , HBsAg（ ＋ ） HBcAg（ - ）, HBsng（ - ） HBeAg（ ＋ ） and HBsAg（ - ） aBcAg（ - ） in the three groups （ P 〉 0.05 ）. The expression of CD8 ＋ CD28 ＋ T lymphocyte in mild hepatitis group was lower than in control group, the expressions of CD8 ＋ CD28 ＋ T lymphocyte and CD8 ＋ CD28 T lymphocyte were higher in moderate and severe hepatitis B groups than in control group（ P 〈 0.05 ）. The expression of CD8 ＋ CD28 ＋ T lymphocyte was increased progressively ,while the expression of CD8 ＋ CD28 - T lymphocyte was decreased progressively with the grade of inflammation（ P 〈 0.01 ）. The expressio＋a of CD8 ＋ CD28 ＋ T lymphocyte in moderate and severe hepatitis patients with HBsAg（ ＋ ）HBcAg（ ＋ ） was lower than in other groups with HBsAg（ ＋ ）HBeAg（ - ）, HBsAg（ - ）HBcAg（ ＋ ） and HBsAg（ - ） HBcAg（ - ） （P 〈 0.05 -P 〈 O. O1 ）. There were no significant difference about the expressions of HBV DNA and HBeAg in different levels of inflammation（ P 〉 O. 05 ）. Conclusions： HBV can reflect the replication of HBV DNA in liver tissue more accurately. As an indirect reflection of immune status, it can be used as a selector of anti-viral treatment indication and a predictor of efficacy. The expression of CD28 on the surface of CD8 ＋ T lymphocyte is closely related with the clearance

关 键 词：肝炎 肝组织 T淋巴细胞 表达 

分 类 号：R575.1[医药卫生—消化系统]