T淋巴细胞亚群及自身抗体的联合检测在丙型肝炎诊疗中的应用  

The application of T cell subsets of peripheral blood and auto-antibody in detecting patients with HCV infection

作　　者：陈杰[1] 邹永光[2] 王少敏[1] 李正[1] 

机构地区：[1]湖北省孝感市中心医院检验科,湖北孝感432100 [2]湖北省孝感市中心医院心内科,湖北孝感432100

出　　处：《中国现代医学杂志》2014年第31期39-42,共4页China Journal of Modern Medicine

基　　金：吴阶平医学基金会肝病医学部肝病实验诊断研究基金(No:LDWMF-SY-2011C003)

摘　　要：目的探讨丙肝患者T淋巴细胞亚群及相关自身抗体检测的意义。方法 196例丙肝患者分为慢性丙肝组及丙肝后肝硬化组。采用间接免疫荧光法(IIF)检测两组患者抗核抗体(ANA)、抗平滑肌抗体(SMA)、抗肝肾微粒体抗体(LKM);采用流式细胞术检测患者外周血T淋巴细胞亚群CD3+、CD4+、CD8+以及CD4+/CD8+,CD4+CD8+(DP)双阳性细胞;采用雅培C8000全自动生化分析仪检测类风湿因子(RF)和丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)。综合分析两组患者各指标差异。结果丙肝后肝硬化组自身抗体阳性率为76.4%,显著高于慢性丙肝组(P<0.01);丙肝后肝硬化组较之慢性丙肝组CD3+和CD4+有所下降,CD8+略有上升,CD4+/CD8+比值下降,CD4+CD8+双阳性细胞明显升高,后两者差异有统计学意义(P<0.01);丙肝后肝硬化患者自身抗体阳性且DP>5%的患者比例为63.6%,显著高于慢性丙肝患者(P<0.01);自身抗体阳性且DP>5%的患者肝损伤指标ALT及AST均高于自身抗体阴性且DP<5%的患者,差异有统计学意义(P<0.01)。结论 T淋巴细胞亚群及相关自身抗体的联合检测对于慢性丙肝患者肝细胞损伤及病情的进展及转归有一定的提示作用,值得我们加以关注。[ Objective ] To investigate the significance of combination detection of T cell subsets of peripheral blood and auto-antibody in patients with HCV infection. [Methods] 196 patients infected with HCV were divided into chronic HCV group and cirrhosis group. Serum levels of ANA, SMA and LKM were detected in all the patients using indirect immunofluorescence assay; The number of CD3＋, CD4＋, CD8＋, CD4YCD8＋ and CD4＋CD8＋（DP） T lym- phocyte in patients with HCV infection were measured by flow cytometry. Levels of ALT, AST and RF were also measured. [ Results ] The positive autoantibody rate of the cirrhosis group was 76.4%, significantly higher than that of the chronic HCV group. The counts of T lymphocyte subsets CD3＋, CD4＋ and the ratio of CD4＋/CD8＋ in the cirrhosis group were lower than that in the chronic HCV group. The counts of T lymphocyte subsets CD8＋ and CD4＋ CD8＋ T cell in the cirrhosis group were higher than that in the chronic HCV group. There was significant different in the ratio of CD4＋/CD8＋ and CD4＋CD8＋ T cell between two groups. The positive autoantibody and DP〉5% rate of the cirrhosis group was 63.6%, significantly higher than that of the chronic HCV group. The value of ALT and AST in the positive autoantibody patients with DP〉5% were higher than that in the negative autoantibody patients with DP〈5%. [Conclusions] Combination detection of T cell subsets of peripheral blood and auto-antibody routinely may be help diagnosis and treatment of chronic hepatitis C patients.

关 键 词：慢性丙型肝炎 T淋巴细胞亚群 自身抗体 

分 类 号：R512.63[医药卫生—内科学]