非活动性HBsAg携带者聚乙二醇干扰素α-2a治疗过程中的CD8＋38＋／CD8＋变化及其临床意义  

Changes in lymphocyte surface expression of CD8 and CD38 molecules in peripheral blood of inactive HBsAg carriers following pegylated interferon α-2a therapy

作　　者：于海滨[1] 马丽娜[1] 柳雅立[1] 画伟[1] 何志敏[1] 鲁俊峰[1] 陈新月[1] 

机构地区：[1]首都医科大学附属北京佑安医院国际医疗部,北京100069

出　　处：《中华肝脏病杂志》2013年第12期895-898,共4页Chinese Journal of Hepatology

基　　金：“十二五”国家科技重大专项（2013ZXl0002002）;北京市科委首都市民健康项目培育（Z111107067311049）;首都卫生发展科研专项（首发2011-2018-08）

摘　　要：目的探讨非活动性HBsAg携带者聚乙二醇干扰素α-2a（Peg—INFo-2a）治疗过程中的CD8＋38＋／CD8＋变化及其意义。方法44例非活动胜HBsAg携带者接受Peg-INFα-2a治疗，根据体质量每周180μg（14例）或135Hg（30例）皮下注射，疗程48周，根据HBsAg是否转阴将患者分为应答组及无应答组。每12周观察肝功能、HBsAg滴度、CD8＋38＋／CD8＋水平。单因素或多因素方差分析比较应答组和无应答组不同时间点的CD8＋CD38＋／CD8＋情况，线性回归方程分析HBsAg下降及ALT升高与CD8＋CD38＋／CD8＋的关系。结果应答组和无应答组12周ALT水平分别为（60．75±24．95）U／L和（37．03±18．45）U／L，应答组较无应答组升高明显（t=2．905，P〈0．01）；应答组及无应答组24周CD8＋38＋／CD8＋分别为71．20％±11．70%和56．79％±7．72％，应答组较无应答组升高明显（F=23．941，P〈0．01）。24周与基线的CD8＋CD38＋／CD8＋差值（8．260／0±3．12％）与12周时的ALT升高值[（17．18±25．78）U／L]呈正相关（r=0．386，P〈0．01）；24周与基线的CD8＋CD38＋／CD8＋差值（8．26％±3．120／0）与24周HBsAg下降的log10值[（0．96±0．40）log10IU／m1]呈正相关（r=0．397，P〈0．01）。结论Peg—INFα-2a治疗非活动性HBsAg携带者过程中，CD8＋38＋／CD8＋明显升高可能系机体免疫被激活的表现，并促进了HBsAg清除。Objective To investigate the effects of pegylated interferon α-2a （Peg-INFα-2a） treatment on expression of CD8 and CD38 surface molecules on lymphocytes from peripheral blood of inactive hepatitis B surface antigen （HBsAg） carriers. Methods Forty-four patients with hepatitis B virus （HBV） chronic infection （CHB） received a 48-week course of Peg-INFα-2a treatment, with 30 administered 135 μg/week and 14 administered 180 gg/week. Every 12 weeks of treatment, the subjects were assessed for HBsAg titer, presence of anti-hepatitis B e （HBe） antibody, serum alanine aminotransaminase （ALT） levels, and lymphocyte surface expression of CD8 and CD38 molecules. Patients were classified as responders and non-responders according to standard parameters. Dynamic differences between the two groups over time were assessed by multivariate repeated measures ANOVA with Greenhouse-Geisser correction and differences at single time points were assessed by univariate ANOVA. Linear regressionanalysis was performed to evaluate the relationship of two variables. Results The responders showed a significantly higher increase in ALT at week 12 （60.75 ± 24.95 U/L vs. non-responders： 37.03 ± 18.45 U/L; t = 2.905, P 〈 0.01） and significantly higher proportion of CD8＋CD38＋ cells at week 24 （71.20 ± 11.70% vs. non-responders： 56.79 ± 7.72%; F = 23.941, P 〈 0.01）. The decline in level of HBsAg at week 24 was positively correlated with the increase inALT level at week 12 （r= 0.386,P 〈 0.01） and with expression levels of CD8 and CD38 molecules on lymphocytes at week 24 （r = 0.397, P 〈 0.01）. Conclusion Lower baseline levels of HBsAg correlated to better Peg-INFα-2a-related HBsAg clearance. Increased expression of CD8 and CD38 on lymphocytes is suggestive of intensive cellular immunity in CHB patients and may be related to HBV-induced hepatocyte damage and may promote the HBsAg clearance.

关 键 词：干扰素Α-2A 肝炎表面抗原 乙型 T淋巴细胞亚群 

分 类 号：R512.62[医药卫生—内科学]