不同临床状态的HBV感染相关肝病患者T淋巴细胞水平和主要细胞因子表达的比较  

Comparison of expression level of T lymphocytes and cytokines in patients with HBV infection and different clinical state

作　　者：聂红明[1] 汪蓉 朱梅萍[1] 高月求[1] 陈建杰[1] 赵刚[1] 张斌[1] 王灵台[1] 

机构地区：[1]上海中医药大学附属曙光医院,上海200021 [2]上海浦东新区中医医院

出　　处：《中西医结合肝病杂志》2015年第1期8-12,共5页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：国家自然科学基金(No.81373618);国家自然科学基金(No.81001492);上海市卫生局新优青培养计划(No.XYQ2011066);上海市科委青年科技启明星计划(No.11QA1406700);上海高校创新团队建设项目(第一期);国家中管局名中医工作室建设项目

摘　　要：目的:对不同临床状态的HBV感染相关肝病患者的T细胞免疫功能状态进行初步研究。方法:分别收集乙型肝炎病毒携带者(As C)、慢性乙型肝炎(CHB)及CHB肝硬化患者的血清,检测患者的T淋巴细胞水平和主要细胞因子表达情况。细胞免疫(CD3、CD4、CD8、NK)采用流式细胞仪检测;细胞因子(IL-2、IL-6、IL-8、IL-10、IFN)采用ELISA方法检测。结果:不同临床类型慢性乙肝病毒感染者血清肝功能、T淋巴细胞亚群、细胞因子水平均具有一定差异,CHB肝硬化患者的TBil、ALP、γ-GT水平最高,并长期处于轻度升高状态;As C的肝功能均正常,CHB活动期患者的ALT、AST水平最高。肝硬化患者的各种细胞因子水平均高于As C和CHB活动期患者,尤其以IL-1、IL-2、SIL-2R、IL-6、IL-8、IL-10最为显著,差异具有统计学意义(P<0.05)。不同临床类型慢性HBV感染者外周血T淋巴细胞亚群差异有显著意义(P<0.01)。不同ALT水平的患者,其外周血T淋巴细胞亚群与细胞因子差异无显著性意义(P>0.05)。结论:不同临床类型慢性HBV感染者,其肝功能、T淋巴细胞亚群、细胞因子水平等均表现为不同状态,CHB肝硬化患者的TBil、ALP、γ-GT水平最高,并长期处于轻度升高状态;肝硬化患者的各种细胞因子水平均高于病毒携带者和CHB活动期患者,而ALT水平对HBV感染者T淋巴细胞亚群、细胞因子水平无明显影响。Objective： To study on the T cell immune function status in patients with different clinical state related chronic infection of HBV. Methods： Serum samples were collected respectively to detect the levels of T lymphocyte and the main cytokine expression in patients with hepatitis B carriers,chronic hepatitis B and liver cirrhosis after hepatitis B infection. Immune cells（ CD3,CD4,CD8,NK） were detected by flow cytometry; cytokines（ IL-2,IL-6,IL-8,IL-10,IFN） were detected by ELISA method. Results： The serum levels of liver function,T lymphocyte subsets,cytokine levels had certain differences in different clinical types of chronic hepatitis B virus infection,TBil,ALP,γ-GT levels were highest and long-term in a mildly elevated status in patients with hepatitis B cirrhosis; liver function of hepatitis B carriers were normal,ALT and AST levels in patients with chronic hepatitis B activities the highest. A variety of cytokines levels in patients with liver cirrhosis were higher than those of carriers and chronic hepatitis B patients,especially IL-1,IL-2,SIL-2R,IL-6,IL-8,IL-10 were the most significant,statistically significant differences（ P 0. 05）. T lymphocyte subsets in peripheral blood in different clinical types of chronic hepatitis B virus infection and abroad had significant difference（ P 0. 01）. Different ALT levels in patients with peripheral blood,T lymphocyte subsets and cytokines had no significant difference（ P 0. 05）. Conclusion： The different clinical types of chronic hepatitis B virus infection,the liver function and T lymphocyte subsets,cytokine level showed different state,liver cirrhosis patients with TBil,ALP,γ-GT levels were highest and long-term in a mildly elevated status; cytokines levels in patients with liver cirrhosis were higher than those of carriers and chronic hepatitis B patients,while the ALT level to T lymphocyte subsets,cytokine levels have no effect on HBV infection.

关 键 词：肝炎 乙型 慢性 T淋巴细胞 细胞因子 

分 类 号：R512.62[医药卫生—内科学]