慢性乙型肝炎患者血清HBVDNA水平与滤泡辅助性T淋巴细胞的关系和意义  

Relationship between serum HBV DNA level and follicular helper T lymphocyte in patients with chronic hepatitis B and its significance

作　　者：王娟华[1] 顾锡炳[1] 朱银芳[1] 华忠[1] 王栋[1] 杨小娟[1] 徐月琴[1] 陆忠华[1] 

机构地区：[1]无锡市传染病医院肝病科,214005

出　　处：《中华实验和临床病毒学杂志》2013年第5期351-353,共3页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的探讨慢性乙型肝炎（CHB）患者HBVDNA水平与外周血滤泡辅助性T淋巴细胞（Tfh）的关系和意义。方法179例HBVDNA阳性、HBeAg阳性、人白细胞抗原（HLA）一A2阳性的CHB患者，用实时荧光定量PCR检测HBVDNA，流式细胞术检测Tfh、HBV特异性CTL，并作IL一21的检测。将179例CHB患者根据HBVDNA水平分为甲、乙两组，甲组86例，HBVDNA水平为10^4。～10^5拷贝／ml，乙组93例，HBVDNA水平为10^6-10^7拷贝／ml，对两组患者进行以上检测指标的比较。结果甲组HBVDNA水平为（4．85±0．37）logl0拷贝／ml，乙组HBVDNA水平为（6．83±0．31）log。0拷贝／ml，t：27．31，P〈0．001，甲组Tfh（5．96±1．59）％，高于乙组（3．71±2．15）％，t=4．92，P〈0．01，IL．21（42．61±15．11）ng／L，高于乙组（14．91±3．15）ng／L，t=8．62，P〈0．01，HBV特异性CTL（0．36±0．08）％，高于乙组（0．18±0．06）％，t=19．99，P〈0．001。结论CHB患者血清HBVDNA水平与外周血Tfh水平有关：HBVDNA水平低者，Tfh水平高，IL-21水平和HBV特异性CTL水平也高。HBVDNA水平高者，Tfh水平低，IL-21水平和ItBV特异性CTL水平也低。基线HBVDNA水平影响抗病毒疗效的机制可能与Tfh水平有关。Objective To explore relationship between HBV DNA level and peripheral blood follicular helper T lymphocyte （Tfh） in patients with chronic hepatitis B （CHB） and its significance. Methods HBV DNA levels of 179 cases of CHB patients with positive HBV DNA, positive HBeAg and positive human leukocyte antigen（HLA）-A2 were tested with real time fluorescent quantitative PCR. Tfh and HBV specific CTL were tested with flow cytometry. IL-21 was also tested. 179 cases of CHB patients were divided into group A and group B based on HBV DNA levels,86 eases in group A, HBV DNA levels were 104-105eopies/ml, 93 cases in group B, HBV DNA levels were 106-107 eopies/ml. Above testing indexes of the two groups were compared. Results HBV DNA levels of group A were （4.85 ± 0. 37）log0 eopies/ml, HBV DNA levels of group B were（6.83 ±0. 31 ）logl0copies/ml,t = 27.31, P 〈 0. 001 ; Tfh of group A was （5.96 ±1.59） % ,higher than that of group B（3.71 ± 2.15） % ,t =4.92, P 〈0.01 ; IL-21 of group A was （42. 61±15.11） ng/L, higher than that of group B（14.91 ±3.15） ng/L, t =8.62, P 〈0.01; HBV specific CTL of group A was（0.36 ± 0. 08）% ,higher than that of group B （0.18 ±0. 06）% , t = 19. 99, P 〈 0. 001. Conclusion Serum HBV DNA level of CHB patients is related to the level of peripheral blood Tfh level： patients with low HBV DNA level have high Tfh level,high IL-21 level and high HBV specific CTL level. Patients with high HBV DNA level have low Tfh level,low IL-21 level and low HBV specific CTL level. The mechanism of baseline HBV DNA level affecting anti-viral therapy may be related to Tfh level.

关 键 词：肝炎 乙型 慢性 DNA T淋巴细胞 白细胞介素21 T淋巴细胞 细胞素性 

分 类 号：R512.62[医药卫生—内科学]