慢性丙型肝炎CD4^+CD25^+CD127^(low/-)Treg细胞的检测价值  

Significance of CD4^+CD25^+CD127^(low/-) regulatory T cells in hepatitis C

作　　者：武晓丽 

机构地区：[1]山东省禹城市人民医院感染科,山东省禹城市251200

出　　处：《世界华人消化杂志》2016年第20期3182-3187,共6页World Chinese Journal of Digestology

摘　　要：目的:探讨慢性丙型肝炎患者外周血CD4^+CD25^+CD127^(low/-)Treg细胞比例对其临床诊治的指导意义.方法:以禹城市人民医院收治并采用派罗欣联合利巴韦林治疗的69例慢性丙型肝炎患者为观察组,同期入院体检的65例健康志愿者为对照组.分别于基线和治疗24 wk后检CD4^+CD25^+CD127^(low/-)Treg比例.分析基线不同病毒载量及肝损伤程度CD4^+CD25^+CD127^(low/-)Treg比例的变化.同时根据停药后24 wk是否获得病毒学应答分为获得持续病毒学应答(sustained virologic response,SVR)组和未获得SVR组,并分析两组CD4^+CD25^+CD127^(low/-)Treg比例在治疗24 wk前后的差异.结果:观察组治疗前外周血CD4^+CD25^+CD127^(low/-)Treg细胞比例高于对照组和治疗(P<0.05).不同HCV RNA载量的患者外周血CD4^+CD25^+CD127^(low/-)Treg细胞比例不同,随着HCV RNA载量的升高,CD4^+CD25^+CD127^(low/-)Treg细胞比例也持续升高,组与组之间差异有统计学意义(P<0.05).治疗48 wk随访24 wk后,观察组SVR率78.3%.无论是基线还是治疗24wk,获得SVR患者的CD4^+CD25^+CD127^(low/-)Treg细胞比例均明显低于未获得SVR者(P<0.05).此外,经相关性分析发现,基线CD4^+CD25^+CD127^(low/-)Treg细胞比例均与肝功能指标AST/ALT呈正相关性(P<0.05).结论:CD4^+CD25^+CD127^(low/-)Treg细胞可能参与了慢性丙型肝炎的发病过程,其临床检测对患者病情诊断和预后评估有指导意义.AIM：To investigate the diagnostic and therapeutic significance of CD4~＋CD25~＋CD127^（low/-）regulatory T（Treg） cell ratio in peripheral blood of patients with chronic hepatitis C.METHODS：Ninety-six chronic hepatitis C patients undergoing polyethylene glycol interferon（PEG-IFN） and ribavirin（RBV）therapy at Yucheng People＇s Hospital were assigned to an observation group,and 65 healthy volunteers were included in a control group.CD4~＋CD25~＋CD127^（low/-）Treg ratio was detected at baseline and 24 wk after treatment.The changes of CD4~＋CD25~＋CD127^（low/-）Treg ratio with different viral levels and liver injury were analyzed.According to whether the patients achieved a virologic response in 24 wk after withdrawal,they were divided into a sustained virologic response（SVR） group or a non-SVR group.The differences between the two groups in CD4~＋CD25~＋CD127^（low/-）Treg ratios were analyzed at baseline and 24 wk after treatment.RESULTS：The proportion of CD4~＋CD25~＋CD127^（low/-） Treg cells at baseline in the observation group was significantly higher than that at baseline in the control group and that at the end of treatment in the observation group（P0.05）.CD4~＋CD25~＋CD127^（low/-）Treg cell ratios of patients with different load of HCV RNA were different.With the increase in HCV RNA load,CD4~＋CD25~＋CD127^（low/-）Treg cell proportion continued to rise significantly（P0.05）.At 24 wk after withdrawal,the rate of SVR in the observation group was 78.3%.The proportion of CD4~＋CD25~＋CD127^（low/-）Treg cells in SVR patients was significantly lower than that of patients without SVR（P 0.05） no matter whether at baseline or at 24 wk after treatment.Correlation analysis showed that the baseline CD4~＋CD25~＋CD127^（low/-）Treg cell proportion was positively correlated with the liver function index AST/ALT（P 0.05）.CONCLUSION：CD4~＋CD25~＋CD127^（low/-） Treg cells may be involved in the pathogenesis of chronic hepatitis,and clinical

关 键 词：慢性丙型肝炎 CD4^+CD25^+CD127^(low/-)Treg细胞 病毒载量 持续病毒学应答 

分 类 号：R512.63[医药卫生—内科学]