乙型肝炎患者外周血各淋巴细胞亚群绝对值的变化及临床意义  

Changes of peripheral blood lymphocyte subsets absolute values in hepatitis B patients

作　　者：王维维[1] 陈惠[1] 王娟娟[1] 费奇力[1] 袁向亮[1] 陈谨[1] 刘宏景[1] 荣婷婷[1] 李美星[1] 沈立松[1] 

机构地区：[1]上海交通大学医学院附属新华医院检验科,上海200092

出　　处：《检验医学与临床》2015年第6期723-726,共4页Laboratory Medicine and Clinic

基　　金：国家自然基金青年项目(81301788);上海市教委青年教师资助计划(JDY11042)

摘　　要：目的分析乙型肝炎患者外周血各淋巴细胞亚群的绝对值的变化,以评估乙型肝炎患者机体的免疫水平。方法选取2012年6月至2014年8月在上海交通大学医学院附属新华医院就诊的109例乙型肝炎肝患者作为乙型肝炎组,另选取20例同期体检健康者作为健康对照组。采集所有研究对象的促凝和肝素抗凝外周血,临床检测乙型肝炎病毒(HBV)抗原抗体免疫指标,采用实时定量聚合酶链反应(PCR)检测HBV-DNA载量,采用流式细胞术检测其外周血各淋巴细胞亚群的百分比与绝对值。并根据乙型肝炎e抗原(HBeAg)表达水平及HBVDNA载量将患者分为HBeAg阳性组与阴性组,以及HBV-DNA阳性组与阴性组,比较外周血各淋巴细胞亚群绝对值。结果乙型肝炎患者外周血CD3+T细胞、CD4+T辅助细胞(CD4+Th细胞)、CD8+杀伤性T细胞(CD8+Tc细胞)、CD19+B细胞绝对数均低于健康对照组(P<0.05),组间CD3-CD16+CD56+自然杀伤性细胞(NK细胞)绝对数比较差异无统计学意义(P>0.05)。HBeAg阴性患者外周血CD3+T、CD4+Th、CD8+Tc及CD19+B细胞绝对值均低于HBeAg阳性患者(P<0.05),但CD3-CD16+CD56+NK细胞绝对值比较差异无统计学意义(P>0.05);HBV-DNA阳性患者CD4+Th细胞绝对值低于HBV-DNA阴性患者(P<0.01),其余各淋巴细胞亚群的绝对值比较差异均无统计学意义(P>0.05)。结论乙型肝炎患者外周血淋巴细胞绝对数量的变化可提示其免疫功能的紊乱。Objective To analyze the changes of absolute values of peripheral blood lymphocyte subsets in the patients with hepatitis B for evaluating their immune level.Methods 109 cases of hepatitis B in our hospital from Jun.2012 to Aug.2014 were selected as the hepatic B group and contemporaneous 20 individuals of healthy physical examination as the healthy control group.The procoagulation and heparin anticoagulation blood was collected in all research subjects and clinically detected the immune indexes of hepatitis B virus（HBV）antigens and antibodies.The real time PCR was adopted to detect HBV-DNA loads and the flow cytometry was adopted to detect the percentages and absolute values of lymphocyte subsets.Results The absolute numbers of CD3^＋T cells,CD4^＋Th cells,CD8^＋Tc cells and CD19^＋B cells were significantly lower than those in the health control group（P〈0.05）.The absolute numbers of CD3-CD16＋CD56＋NK cells had no statistically significant differences between the two groups（P〉0.05）.The absolute values of CD3^＋T cells,CD4^＋Th cells,CD4^＋Tc cells and CD19＋B cells in the HBeAg negative patients were lower than those in the HBeAg positive patients（P〈0.05）,but the absolute value of CD3-CD16^＋CD56^＋NK cells had no statistical difference（P〉0.05）.The absolute value of CD4^＋Th cells in the HBV-DNA positive patients was lower than that in the HBV-DNA negative patients（P〈0.01）.The absolute values of other lymphocyte subsets had no statistical differences between the two groups（P〉0.05）.Conclusion The absolute number changes of peripheral blood lymphocytes in the hepatic B patients could prompt their immune function disorder.

关 键 词：乙型肝炎 淋巴细胞亚群绝对数 细胞免疫 流式细胞术 

分 类 号：R512.62[医药卫生—内科学]