慢性乙型肝炎患者Th17/Tc17影响病毒复制和肝细胞损伤  

Correlation of Th17/Tc17 ratio with virus load and liver function in patients with chronic hepatitis B

作　　者：王娟华[1] 胡敏涛[1] 吴杭源[1] 苏婷婷[1] 汪铮[1] 杜合娟[1] 顾锡炳[1] 黄利华[1] 李莹[2] 

机构地区：[1]无锡市第五人民医院,江苏省无锡市214000 [2]兰州大学第一医院普外二科,甘肃省兰州市730000

出　　处：《世界华人消化杂志》2014年第30期4638-4641,共4页World Chinese Journal of Digestology

摘　　要：目的:本研究试图通过评价乙型病毒性肝炎患者的部分T细胞免疫指标与病毒复制水平和肝细胞损伤水平之间的关系,了解乙型病毒性肝炎患者的T细胞免疫在疾病发生发展过程中的作用.方法:将慢性乙型病毒性肝炎患者31例按照HBV DNA水平分为高、中、低复制3组,比较3组间CD3+、CD4+、CD8+、CD4+/CD8+、Th1、Th2、Th1/Th2、Tc1、Th17、Tc17、Th17/Tc17、Treg、Th17/Treg等多项T细胞亚群细胞数量;按照谷丙转氨酶水平分为肝细胞轻、中、重损伤3组,比较3组间多项T细胞亚群细胞数量,以此评价慢性乙型病毒性肝炎患者的部分T细胞免疫指标与病毒复制水平和肝细胞损伤水平之间的关系.结果:病毒低度复制患者Th17细胞(5.81%)和Th17/Treg(23.54)显著高于中/高度复制患者Th17细胞(2.51%/2.23%)和Th17/Tr e g(19.42/9.85);正常肝功患者T h2细胞(6.75%)、Tc1细胞(70.43%)、Th17/Tc17(71.18)均显著高于轻/重度肝细胞损伤患者Th2细胞(3.09%/3.58%)、Tc1细胞(36.97%/35.86%)、Th17/Tc17(11.35/12.58),重度损伤患者Tc17细胞(0.42%)显著少于轻度损伤患者Tc17细胞(1.69%).结论:慢性乙型病毒性肝炎患者T细胞免疫状态与病毒复制水平和肝细胞损伤水平关系密切,其中Th17/Tc17起重要作用.AIM： To assess the role of cellular immunity in the development of chronic hepatitis B. METHODS： Patients with chronic hepatitis B were collected. Alanine aminotransferase（ALT） and viral load were detected. CD3＋, CD4＋, CD8＋, CD4＋/CD8＋ ratio, Th1, Th2, Th1/Th2 ratio, Tc1, Th17, Tc17, Th17/Tc17 ratio, regulatory T cells（Treg）, and Th17/Treg ratio were detected by flow cytometry（FCM）. The correlations between the immune indicators and transaminase and viral load were evaluated.RESULTS： Th17 percentage and Th17/Treg ratio were significantly higher in chronic hepatitis B patients with low viral load than in those with normal/high viral load（5.81% vs 2.51%, 2.23%; 23.54 vs 19.42, 9.85）. Th2 percentage, Tc1 percentage, and Th17/Tc17 ratio were significantly higher in chronic hepatitis B patients with normal liver function than in those with mild/severe liver damage（6.75% vs 3.09%, 3.58%; 70.43% vs 36.97%, 35.86%; 71.18 vs 11.35, 12.58）. Tc17 percentage was significantly lower in chronic hepatitis B patients with severe liver dysfunction than in those with mild liver dysfunction（0.42% vs 1.69%）. CONCLUSION： Cellular immune status in patients with chronic hepatitis B has an impact on viral load and liver dysfunction level, in which Th17/Tc17 ratio may play an important role.

关 键 词：慢性乙型肝炎 细胞免疫 Th17/Tc17 HBV DNA 谷丙转氨酶 

分 类 号：R512.62[医药卫生—内科学]