乙型肝炎患者外周血单核细胞CD14^+ CD16^+亚群及HLA-DR的检测及其意义  

Significance of Detection of the Monocyte CD14^+CD16^+ Subsets and HLA-DR in Hepatitis B Patients by FCM

作　　者：杨喆娟[1] 董慧慧[2] 林志益[1] 李世波[1] 李绍佐[1] 刘华生[1] 李红玲[1] 

机构地区：[1]浙江省舟山医院感染性疾病科,316004 [2]浙江大学医学院附属第一医院感染科,310003

出　　处：《放射免疫学杂志》2013年第6期808-810,共3页Journal of Radioimmanology

摘　　要：目的:通过检测乙型肝炎患者外周血单核细胞各亚群分布情况以及HLA-DR表达水平,探讨慢性乙型肝炎患者外周血中CD14+CD16+单核细胞及HLA-DR的表达特点,以及与疾病进程之间的关系。方法:利用流式细胞仪(FCM)检测50例慢性乙型肝炎患者,其中21例免疫耐受(IT)患者、29例免疫活化(IA)患者,及31例正常人外周血CD14、CD16、HLA-DR的表达。同时调查肝功能、乙肝五项和血清HBV DNA等相应临床资料。结果:免疫活化组(IA)的CD14+CD16+亚群比率明显高于正常对照组和免疫耐受组(IT)(P<0.01);单核细胞CD14+CD16+亚群HLA-DR表达明显高于CD14++CD16-亚群(P<0.01);乙型肝炎患者CD14+CD16+单核细胞比率与ALT呈正相关(r=0.876,P<0.01),与HBV DNA载量成负相关(r=-0.267,P<0.01)。结论:CD14+CD16+单核细胞可能在乙型肝炎患者外周血中参与调节针对HBV的免疫反应,CD14+CD16+单核细胞与HBV复制和肝脏炎症之间存在相关性,因此检测单核细胞CD14+CD16+亚群及HLA-DR水平对于了解乙型肝炎患者疾病进程具有重要的临床应用价值。Objective To investigate the mononuclear cell subsets distribution and HLA-DR of the peripheral blood in hepatitis B patients and analysis the relationship among CD14^＋CD16^＋ monocytes , HLA-DR and the progression of disease. Methods In 50 chronic hepatitis B patients, including 21 patients in immune tolerant phase and 29 patients in immune active phase patients, and 31 normal controls, the expression levels of CD 14 , CD 16, HLA-DR were measured by flow-cytometry. Besides,clinical variables were surveyed for each subjects. Results The expression levels of CD 14 , CD16 on monecyte in group of immune active patients showed significant difference as compared to normal control and patients in immune tolerant phase（P 〈0.01 ） . The expression of HLA-DR on monocyte CD14^＋ CD16^ ＋ subsets proved markedly differences as compared to monecyte CD14^ ＋ ＋ CD16 subsets （P 〈 0.01 ）. In chronic hepatitis B patients,elevated proportions of circulating CD14^ ＋ CD16^ ＋ monocytes were correlated with increased serum ALT levels （r = 0.876,P 〈0.01） and decreased HBV DNA loads（r= -0.267,P 〈0.01）. Conclusion Monecyte CD14＋ CD16＋subsets may play an active role in immune response to HBV infection. HBV replication or liver haflammation in chronic HBV infection correlates with the monoeyte CD14 ^＋ CD16^ ＋ subsets. Detection of monecyte CD14^＋ CD16^ ＋ subsets and HLA-DR provides an important clinieal value.

关 键 词：单核细胞CD14^+ CD16^+ 亚群 HLA-DR 乙型肝炎 流式细胞分析法 

分 类 号：R512.62[医药卫生—内科学]