乙型肝炎肝硬化患者病毒基因型与滤泡辅助性T淋巴细胞及白细胞介素-21的关系和意义  

Relationship between viral genotypes and follicular helper T lymphocyte and interleukin-21 and its significancein patients with HBV-induced hepatic cirrhosis

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

机构地区：[1]无锡市第五人民医院肝病科,214005

出　　处：《中华实验和临床病毒学杂志》2014年第5期327-329,共3页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的 探讨乙型肝炎肝硬化患者不同HBV基因型与外周血滤泡辅助性T淋巴细胞（Tfh）及白细胞介素-21 （IL-21）的关系和意义.方法 59例人白细胞抗原（HLA）-A2阳性的乙型肝炎肝硬化患者作HBV基因型检测,比较B、C基因型感染者之间Tfh、IL-21的差别,并探讨其意义.结果 59例乙型肝炎肝硬化患者中,C基因型36例（61.02％）,B基因型22例（37.29％）,B、C混合型1例（1.69％）,C基因型外周血Tfh水平（2.89％±1.44％）,低于B基因型（4.65％±1.37％）,t=3.01,P＜0.01,IL-21水平（14.62±2.12 ng/L）,低于B基因型（32.27±11.25 ng/L）,=4.12,P＜0.01,HBV特异性细胞毒性T淋巴细胞（CTL）水平（0.17％±0.02％）,低于B基因型（0.37％±0.03％）,t=3.12,P＜0.01,HBV DNA水平（6.95±0.75log10拷贝/ml）,高于B基因型（5.02 ±0.36log10拷贝/ml）,=3.03,P＜0.01.结论 与乙型肝炎肝硬化B基因型感染者相比,C基因型感染者的外周血Tfh水平较低,引起IL-21和HBV特异性CTL水平降低,导致HBV DNA水平较高.Objective To explore relationship between different HBV genotypes and peripheral blood follicular helper T lymphocyte （Tfh） and interleukin-21 （IL-21） and its significance in patients with HBV-induced hepatic cirrhosis.Methods HBV genotypes were tested in 59 cases of cirrhotic hepatitis B with positive human leukocyte antigen （HLA）-A2,differences of Tfh and IL-21 between patients infected with genotype B and genotype C were compared and its significance was investigated.Results In 59 cases of cirrhotic hepatitis B,36 cases （61.02%） were infected with genotype C,22 cases （37.29%） were infected with genotype B and 1 case （1.69%） was infected with genotype B and C.Peripheral blood Tfh level of genotype C was（2.89% ± 1.44%）,lower than that of genotype B （4.65% ± 1.37%）,t =3.01,P 〈0.01,IL-21 level of genotype C was （14.62 ± 2.12 ng/L）,lower than that of genotype B （32.27 ± 11.25ng/L）,t =4.12,P 〈0.01,HBV specific cytotoxic T lymphocyte（CTL）level of genotype C was （0.17% ±0.02%）,lower than that of genotype B（0.37% ±0.03%）,t =3.12,P 〈0.01,HBV DNA level of genotype C was （6.95 ± 0.75log10copies/ml）,higher than that of genotype B （5.02 ± 0.36 log10 copies/ml）,t =3.03,P 〈 0.01.Conclusion Compared with cirrhotic hepatitis B patients infected with genotype B,peripheral blood Tfh level of patients infected with genotype C was lower,causing lower IL-21 level and lower HBV specific CTL level,which result in higher HBV DNA level.

关 键 词：肝炎 乙型 肝硬化 基因型 T淋巴细胞 白细胞介素-21 DNA 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]