慢性HBV感染及其相关肝病患者外周血T细胞亚群的变化  

Differential profiles of T-cell subsets are present in peripheral blood of patients with various progressive forms of hepatitis B infection

作　　者：王慰[1] 郑欢伟[1] 任桂芳[1] 冯爱东[1] 刘莲[1] 李兵顺[1] 

机构地区：[1]石家庄市第五医院感染二科,石家庄050021

出　　处：《临床肝胆病杂志》2013年第4期276-279,共4页Journal of Clinical Hepatology

基　　金：河北省卫生厅科研基金项目(20090607)

摘　　要：目的观察不同临床类型HBV感染者外周血T淋巴细胞亚群的差异,探讨HBV对人体T细胞免疫的影响及其可能机制,不同类型慢性HBV感染者免疫失衡的规律。方法用流式细胞仪技术检测患者外周血T细胞亚群。慢性HBV感染者318例,其中HBV携带者8例,慢性乙型肝炎231例,肝炎后肝硬化61例,原发性肝癌18例,观察患者的T淋巴细胞亚群、HBV DNA等。同时收集22名健康志愿者的新鲜血检测T淋巴细胞亚群。结果不同临床类型HBV感染者外周血CD3+T、CD4+T、CD8+T细胞百分数低于正常对照组,差别均有统计学意义(P<0.05或P<0.01),CD4+/CD8+比正常对照组低,但差异均无统计学意义(P>0.05)。结论慢性HBV感染随着病情进展,由慢性肝炎→肝硬化→肝癌,直至细胞免疫功能逐渐衰退。慢性HBV感染的不同阶段的细胞免疫紊乱各具特点,就不同类型患者应采用不同的免疫调节治疗手段。Objective To determine whether various progressive forms of hepatitis B virus （HBV） infection, from HBV carriers to chronic hepatitis B （CHB） without complication or with cirrhosis or hepatoeellular carcinoma （HCC）, are associated with differential profiles of T lymphocyte subsets in peripheral blood. Methods Between 2009 and 2011,318 HBV infections presented for treatment at our hospital, in- cluding eight HBV carriers, 231 cases of CHB, 61 cases of CHB -related cirrhosis, and 18 cases of CHB -related HCC. Peripheral blood samples were collected from each patient, as well as from 22 non -HB~ infected individuals （to serve as healthy controls）. The various T lymphocyte subsets （ CD3 ＋ , CIM ＋ , and CD8 ＋ ） were detected by flow cytometry and expressed as percentages of the entire T lymphocyte cell population. HBV DNA presence and quantity was assessed by fluorescence real - time polymerase chain reaction. Differences between groups were assessed by the Kruskal - Wallis H test. Pairwise comparisons were made by Dunnett＇ s test and multiple comparisons were made by the least significant difference test. Results Compared to the healthy control group, all four of the HBV - infected groups showed signifi- cantly less peripheral blood T cell percentages of CD3 ＋ （ all, P 〈 0.01 ） and CD4 ＋ （ all, P 〈 0.01 ） ; however, only the HBV - infected groups of HBV - related cirrhosis and HCC showed significantly less percentages of CD8 ＋ （ P 〈 0.05 ）. None of the HBV - infected groups showed a significantly different CIM ＋/CD8 ＋ ratio from that detected in the healthy control group （ all, P 〉 0.05 ）. There was a general trend in decreasing percentages of the peripheral blood T cell subsets that followed increases in hepatitis disease progression （ HBV carriers 〉 CHB 〉 HBV - related cirrhosis 〉 HBV - related HCC）. Conclusion Progression of the HBV infection to more severe forms of liver disease is accompanied by ebbs in the CD3 ＋ , CD4＋ , and CD8 ＋ T c

关 键 词：肝炎病毒 乙型 T淋巴细胞亚群 

分 类 号：R512.62[医药卫生—内科学]