慢性丙型肝炎患者外周血T淋巴细胞亚群变化的临床分析  

Clinical analysis of changes on peripheral blood T lymphocyte subsets in patients with chronic hepatitis C

作　　者：童永喜[1] 汪明珊[1] 黄海军[1] 叶荣夏[2] 潘克女[3] 潘红英[1] 

机构地区：[1]浙江省人民医院感染科,杭州310014 [2]杭州市第六人民医院感染科,310023 [3]杭州市第六人民医院检验科,310023

出　　处：《国际流行病学传染病学杂志》2016年第3期173-176,共4页International Journal of Epidemiology and Infectious Disease

基　　金：浙江省科技厅公益项目（2016C37149）

摘　　要：目的：分析慢性丙型肝炎（CHC）患者外周血T淋巴细胞亚群（CD3^＋、CD4^＋和CD8^＋细胞）以及调节性T淋巴细胞（CD4^＋CD25^＋Treg）表达与HCV RNA水平之间的关系。方法选取CHC 患者128例，根据HCV RNA水平高低将他们分为HCV RNA阴性组48例，低病毒组40例（HCV RNA〈105 IU/mL），高病毒组40例（HCV RNA≥10^5 IU/mL），另外选取30名健康体检者作为对照组。检测4组样本的外周血T淋巴细胞亚群和调节性T淋巴细胞，分析各组间的差异。结果 CD4^＋CD25^＋Treg表达率在HCV RNA高病毒组、低病毒组、阴性组与健康对照组分别为（13.57±1.87）%、（9.38±1.74）%、（5.95±1.28）%和（5.89±1.15）%，差异存在统计学意义（F=35.28， P〈0.01）。 CD4^＋CD25^＋Treg水平随HCV RNA的升高而升高，两者呈正相关（r=0.625， P〈0.05）。 CD3^＋、CD4^＋及CD4^＋/CD8^＋在4组间的差异均有统计学意义（F=21.51、28.52和15.51，P均〈0.01），其中外周血CD4^＋百分率及CD4^＋/CD8^＋在高病毒组均低于其他3组，在低病毒组均低于健康对照组和阴性组（P均〈0.05）。结论 CHC患者外周血CD4^＋CD25^＋Treg升高与HCV RNA含量正相关，提示它可能参与了HCV感染慢性化的进程；外周血CD4^＋百分率及CD4^＋/CD8^＋随着HCV RNA水平的升高而明显降低，提示病毒复制水平越高，机体免疫抑制就越明显。Objective To analyze the relationship of the expression of peripheral blood T lymphocyte subsets （CD3^＋, CD4^＋and CD8^＋lymphocytes） and regulatory T cells （CD4^＋CD25^＋Treg） with the level of HCV RNA in the patients with chronic hepatitis C （CHC）. Methods According to the level of HCV RNA, 128 CHC cases were divide into HCV RNA negative group （n=48）, low virus group （n=40, HCV RNA〈105 IU/mL） and high virus group （n=40, HCV RNA ≥10^5 IU/mL）, and other 30 healthy persons were selected as control. The peripheral blood T lymphocyte subsets and regulatory T lymphocytes of 4 groups were detected. The differences were analyzed among the 4 groups. Results The expression of CD4^＋CD25^＋Treg in high virus group, low virus group, negative group and control group were （13.57±1.87）%, （9.38±1.74）%, （5.95±1.28）% and （5.89±1.15）%, respectively. There were statistical differences among the 4 groups （F=35.28, P〈0.01）. The level of CD4^＋CD25^＋Treg increased with the increasing of HCV RNA. The level of CD4^＋CD25^＋Treg showed positive correlation with HCV RNA （r=0.625, P〈0.05）. The differences of CD3^＋, CD4^＋and CD4^＋/CD8^＋among the 4 groups had statistical significances （F=21.51, 28.52 and 15.51, P all 〈0.01）. Among them, CD4^＋ lymphocyte and CD4^＋/CD8^＋ in high virus groupwere lower than other 3 groups, and those in low virus group were lower than negative group and control group （P all〈0.05）. Conclusions The percentage of CD4^＋CD25^＋Treg in patients with CHC has positive correlation with the level of HCV RNA. It suggests that CD4^＋CD25^＋Treg may play a role in chronic progress of HCV infection. The percentage of CD4^＋lymphocyte and CD4^＋/CD8^＋decrease significantly with the increasing of HCV RNA level, which demonstrates that the higher the level of HCV RNA is, the more obvious the depression of immunity will be.

关 键 词：肝炎 丙型 HCV RNA T淋巴细胞 调节 T淋巴细胞亚群 

分 类 号：R512.63[医药卫生—内科学]