乙型肝炎病毒相关慢加急性肝衰竭患者外周血T淋巴细胞比例的特征及其意义  

The characteristics and significance of T lymphocyte in peripheral blood in patients with HBV related acute-on-chronic liver failure

作　　者：曹慧[1] 谭善忠[2] 孙薇薇[1] 沈建军[1] 肖倩[1] 梁重锋[1] 蒋淑莲[1] 

机构地区：[1]南京市第二医院中西医结合科,210003 [2]南京中医药大学第一临床医学院

出　　处：《中华临床医师杂志（电子版）》2013年第19期18-20,共3页Chinese Journal of Clinicians(Electronic Edition)

基　　金：南京市医学科技项目(DYY056);南京市科技计划项目(201104004);江苏省"六大人才高峰"项目(苏人社发〔2010〕555号);江苏省中医药领军人才项目(LJ200922);江苏省"333高层次人才培养工程"项目(苏人才〔2011〕15号)

摘　　要：目的探讨乙型肝炎病毒相关慢加急性肝衰竭患者外周血T淋巴细胞的变化及意义。方法乙型肝炎病毒相关慢加急性肝衰竭患者(肝衰竭组)与慢性乙型肝炎患者(慢乙肝组)各50例,以门诊同期健康体检者(健康对照组)20名为对照,应用流式细胞仪测定外周血CD3+T淋巴细胞所占比例、CD4+和CD8+T淋巴细胞所占比例及比值、CD4+CD25+调节性T淋巴细胞所占比例。结果肝衰竭组外周血CD3+T淋巴细胞[(35.48±23.44)%]、CD8+T淋巴细胞[(37.66±13.28)%]、CD4+CD25+调节性T淋巴细胞[(0.72±1.07)%]所占比例与健康对照组[分别为(50.31±12.09)%、(42.05±9.26)%、(2.93±1.31)%]和慢乙肝组[分别为(49.72±20.11)%、(41.95±8.63)%、(3.47±2.29)%]比较均下降,差异有统计学意义(P<0.05)。结论乙型肝炎病毒相关慢加急性肝衰竭一旦形成,有别于慢性乙型肝炎时期,外周血总T淋巴细胞、CD8+T淋巴细胞以及CD4+CD25+调节性T淋巴细胞等效应T淋巴细胞便处于耗损状态。Objective To investigate the changes and significance of the peripheral blood T lymphocytes for patients with hepatitis B virus-related acute-on-chronic liver failure. Methods 50 patients with hepatitis B virus-related acute-on-chronic liver failure （liver failure group）, 50 patients with chronic hepatitis B （chronic hepatitis B group）, and 20 healthy persons taking physical examination in the corresponding period （healthy control group） were selected to determine the proportions of CD3＋, CD4＋, CD8＋ T lymphocytes and CD4＋CD25＋ regulatory T cells （regulatory T cells, Tregs） in peripheral blood by flow cytometry. Results The proportions of the peripheral blood CD3＋（35.48%±23.44%）, CD8＋ T lymphocytes（37.66%±13.28%） and CD4＋CD25＋ Tregs （0.72%±1.07%） of the patients with hepatitis B virus-related acute-on-chronic liver failure were significantly lower than that of the healthy control group （respectively 50.31%± 12.09%; 42.05%±9.26%; 2.93%± 1.31%） and chronic hepatitis B group （respectively 49.72%± 20.11%; 41.95% ± 8.63%; 3.47% ± 2.29%） （P〈 0.05）. Conclusion Once the hepatitis B virus-related acute-on-chronic liver failure formed, the total peripheral blood T lymphocytes, CD8＋ T lyrnphocytes, CD＋CD25＋ Tregs and other effector cells would be in the ＂wear and tear＂ state.

关 键 词：肝功能衰竭 乙型肝炎病毒相关慢加急性肝衰竭 T淋巴细胞 T淋巴细胞 调节性 特征 

分 类 号：R575.3[医药卫生—消化系统]