乙型肝炎患者外周血T淋巴细胞亚群变化及临床意义  

T lymphocyte subsets in peripheral blood of hepatitis B patients and its clinical signifi cance

作　　者：王晗[1] 苑文雯[1] 李妍[1] 杨宁[1] 谢娜[2] 朱剑功[1] 李沛然[1] 王大刚[1] 何叶莉 郭桐生[1] 

机构地区：[1]解放军302医院临床检验医学中心全军感染病临床实验诊断中心,北京100039 [2]解放军302医院感染性疾病研究与诊疗中心,北京100039

出　　处：《解放军医学院学报》2014年第9期909-911,共3页Academic Journal of Chinese PLA Medical School

摘　　要：目的观察不同类型乙型肝炎病毒(hepatitis B virus,HBV)感染者外周血T淋巴细胞亚群变化特点。方法对我院2013年6-11月门诊及住院的200例乙肝患者和50例健康对照者采用流式细胞术(flow cytometry,FCM)检测外周血淋巴细胞(CD45+)、T淋巴细胞(CD45+CD3+、CD45+CD3+CD4+、CD45+CD3+CD8+)、B淋巴细胞(CD45+CD3-CD19+)、NK淋巴细胞(CD45+CD3-CD16+56+)百分比和细胞绝对计数。结果急性乙型肝炎组T淋巴细胞总数、CD4+和CD8+T淋巴细胞数较健康对照组显著升高(P<0.01)。慢性乙型肝炎组、肝硬化组和肝衰竭组:T淋巴细胞总数、CD4+和CD8+T淋巴细胞数、CD4+/CD8+比值均较健康对照组降低,其中肝衰竭组<肝硬化组<慢性乙型肝炎组。慢性乙型肝炎组CD4+淋巴细胞百分比较健康对照组显著降低(P<0.01)。肝硬化组CD4+淋巴细胞百分比较慢性乙型肝炎组显著降低(P<0.01),CD8+T淋巴细胞百分比显著升高(P<0.01)。肝衰竭组T淋巴细胞和CD4+T淋巴细胞百分比较肝硬化组显著降低(P<0.01)。结论乙型肝炎患者CD4+T淋巴细胞持续降低,与疾病病程发展密切相关。Objective To observe the characteristics of T lymphocyte subsets in peripheral blood of hepatitis B patients. Methods Peripheral T-lymphocytes （CD45＋CD3＋, CD45＋CD3＋CD4＋, CD45＋CD3＋CD8＋）, B-lymphocytes （CD45＋CD3-CD19＋）, NK- lymphocytes （CD45＋CD3- CD16＋56＋） in 200 hepatitis B patients who visited our outpatient department in our hospital from June 2013 to November 2013 and in 50 healthy controls were detected by flow cytomentry. Results The total number of T lymphocytes and the number of CD4＋ and CD8＋T were significantly higher in acute hepatitis B patients than in healthy controls （P 〈 0.01）. The total number of T lymphocytes, the number of CD4＋ and CD8＋ T lymphocytes and the CD4＋/CD8＋ T lymphocytes ratio were significantly lower in chronic hepatitis B patients, cirrhotic patients and liver failure patients than in healthy controls （P 〈 0.01）. The percentage of CD4＋ lymphocytes was significantly lower in chronic hepatitis B patients than in healthy controls and in cirrhotic patients than in chronic hepatitis B patients while the CD8＋ T lymphocytes ratio was significantly higher in cirrhotic patients than in chronic hepatitis B patients and the T lymphocytes and CD4＋ T lymphocytes ratio was significantly lower in liver failure patients than in cirrhotic patients （P 〈 0.01）. Conclusion The number of CD4＋T lymphocytes and cellular immune function decrease in hepatitis B patients, thus inducing persistent HBV infection. Peripheral T lymphocyte subsets are closely related with the progress of disease.

关 键 词：乙型肝炎病毒 T淋巴细胞 流式细胞术 

分 类 号：R575.1[医药卫生—消化系统]