HBV感染患者病毒载量对外周血T淋巴细胞、细胞因子及肝功能的影响  

Influence of viral load on peripheral blood T lymphocytes,cytokines,and liver function of patients with HBV infection

作　　者：鲁晓娟[1] 寇应琳 陈妍[3] 宋作哲 侯园园[1] 

机构地区：[1]郑州铁路职业技术学院医学技术系,河南郑州451460 [2]护理学院,河南郑州451460 [3]郑州市第二人民医院检验科,河南郑州450006 [4]郑州大学第三附属医院·河南省人类精子库,河南郑州450000

出　　处：《中华医院感染学杂志》2017年第1期63-66,共4页Chinese Journal of Nosocomiology

基　　金：河南省教育厅科科学技术研究重点项目(142202363144)

摘　　要：目的探讨乙型肝炎病毒(HBV)感染患者病毒载量对外周血T淋巴细胞、细胞因子及肝功能的影响。方法 2015年5月-2016年5月分别采用酶偶联法、流式细胞术和酶联免疫吸附法检测460例HBV感染患者,其中按血清HBV-DNA拷贝数分为阴性组(0~<103 copies/ml)96例、低拷贝组(103~<105 copies/ml)132例、中拷贝组(105~<107 copies/ml)115例和高拷贝组(≥107 copies/ml)117例,对比各组的肝功酶学指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酸转移酶(GGT)]、T淋巴细胞表面标志物(CD4+、CD8+)和细胞因子[白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、促血管生成素-2(Ang-2)和肿瘤坏死因子-α(TNF-α)]水平。结果高拷贝组血清ALT、AST、GGT、IL-2、IL-6和TNF-α水平最高,分别为(231.6±69.2)U/L、(196.4±52.1)U/L、(224.7±62.8)U/L、(19.3±3.2)ng/L、(28.7±5.2)ng/L和(30.1±7.1)ng/L,并且随着HBV-DNA拷贝数降低,水平不断下降;不同HBV-DNA拷贝组CD4+T淋巴细胞、CD8+T淋巴细胞比例比较,差异无统计学意义;经Pearson检验,血清ALT、AST和GGT水平与血清IL-2、IL-6和TNF-α水平呈显著相关性(P<0.05)。结论 HBV感染可引起乙型肝炎患者的肝功能损害,但不直接影响T淋巴细胞亚群分布,通过细胞因子IL-2、IL-6和TNF-α水平检测可一定程度上反应肝细胞的损害程度以及机体的免疫状态。OBJECTIVE To explore the influence of viral load on peripheral blood lymphocytes, cytokines, and liver function of patients with hepatitis B virus （HBV） infection. METHODS From May 2015 to May 2016, totally 460 patients with HBV infection were detected by respectively using enzyme coupling method, flow cytometry, and en- zyme linked immunosorbent assay, the enrolled patients were divided into the negative group with 96 cases （0-〈10^3 copies/ml）, the low copy group with 132 cases （10^3 〈10^5 copies/ml）, the moderate copy group with 115 cases （10^5 〈107 copies/ml）, and the high copy group with 117 cases （more than 107 copies/ml） according to the copy number of serum HBV-DNA. The levels of liver enzyme indexes such as alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, glutamate transferase （GGT）, T lymphocyte surface markers like CD4^＋ and CD8^＋ , and cytokines such as interleukin-2 （IL-2）, interleukin-6 （IL-6）, angiogenin-2 （Ang-2） and tumor necrosis factor-α（TNF-α） were determined and compared among the four groups. RESULTS The levels of serum ALT, AST, GGT, IL-2, IL-6, and TNF-α were highest in the high copy group, which were （231. 6 ± 69. 2）U/L, （196.4±52.1）U/L, （224.7±62.8）U/L, （19.3±3.2）ng/L, （28.7±5.2）ng/L, and （30. l±7.1）ng/L, re- spectively; they declined with the decrease of copy number of HBV-DNA. There was no significant difference in the proportion of CD4^＋ T lymphocyte or CD8^＋ T lymphocyte among the groups with different copies of HBV-DNA. The Pearson test showed that the levels of serum ALT, AST, and GGT were remarkably associated with the levels of serum IL-2, IL-6, and TNF-α （P〈0.05）. CONCLUSION The HBV infection may induce the liver damage of the patients with hepatitis B but dose not show direct impact on the dis^ribmion of T lymphocytes. The detection of the levels of cytokines IL-2, IL-6, and TNF-α, to some extent, can reflect the degree of damage of hepatocyte and immune state.

关 键 词：乙型肝炎病毒 T淋巴细胞 细胞因子 肝功能 

分 类 号：R512.62[医药卫生—内科学]