慢性乙型肝炎及乙型肝炎后肝硬化、肝癌患者外周血辅助性T淋巴细胞表达水平分析  

Expression Levels of Helper Lymphocyte T in Peripheral Blood of Patients with Chronic Hepatitis B,Liver Cirrhosis after Hepatitis B and Hepatocellular Carcinoma

作　　者：侯春阳[1] 马玉梅[1] 刘莉[2] 李宗芬 

机构地区：[1]沈阳市第六人民医院感染二科病房,沈阳110006 [2]辽宁省疾病预防控制中心,沈阳110005 [3]建平县疾病预防控制中心,辽宁建平122400

出　　处：《临床误诊误治》2017年第5期98-101,共4页Clinical Misdiagnosis & Mistherapy

基　　金：辽宁省科技惠民计划专项资助项目(2013GS210102)

摘　　要：目的探讨慢性乙型肝炎(chronic hepatitis B,CHB)及乙型肝炎后肝硬化(liver cirrhosis,LC)、肝癌(hepatocellular carcinoma,HCC)患者外周血辅助性T淋巴细胞(Th)的表达水平。方法选择2014年1—3月建平县疾病预防控制中心传染病网络报告的HBV 34例(CHB组)及2014年1—12月在建平县疾病预防控制中心登记注册的乙型肝炎后LC 31例(乙型肝炎后LC组)和乙型肝炎后HCC 29例(乙型肝炎后HCC组),另选择2014年1—3月参加建平县医院体格检查结论健康的志愿者30例(对照组)。所有入选患者均进行Th(CD3+、CD4+、CD8+、CD4+/CD8+)检测并比较。结果 4组外周血Th各指标值总体比较差异均有统计学意义(P<0.05)。CHB组、乙型肝炎后LC组及乙型肝炎后HCC组外周血CD3+、CD4+及CD4+/CD8+值均明显低于对照组,外周血CD8+值均明显高于对照组;乙型肝炎后HCC组外周血CD3+、CD4+及CD4+/CD8+值均明显低于CHB组及乙型肝炎后LC组,而CD8+值明显高于CHB组及乙型肝炎后LC组;乙型肝炎后LC组外周血CD3+、CD4+及CD4+/CD8+值均明显低于CHB组,而CD8+值明显高于CHB组,差异均具有统计学意义(P<0.05)。结论 CHB及乙型肝炎后LC、HCC患者均存在明确外周血Th异常表达,乙型肝炎后HCC患者最为严重。Objective To investigate expression levels of helper T lymphocyte （Th） in peripheral blood of patients with chronic hepatitis B （CHB） , liver cirrhosis （LC） after hepatitis B infection and hepatocellular carcinoma （HCC）. Methods A total of 34 hepatitis B virus （HBV） patients （CHB group） reported in legal infectious diseases network of Jianping County from January to March in 2014, 31 LC patients after hepatitis B infection （LC group） registered from January to December 2014, 29 HCC patients after hepatitis B infection （HCC group） registered in disease prevention and control center of Jianping County from January to March in 2014 and 30 healthy people taking physical examination from January to March in 2014 （ control group） were recruited in this study. Detections of T cells （ CD3 ＋ , CD4 ＋ , CD8 ＋ , CD4 ＋ / CD8 ＋ ） were performed for all the groups. Results There were significant differences in Th index values in peripheral blood in the four groups （P 〈0.05）. Values of CD3 ＋ , CD4 ＋ and CD4 ＋/CD8 ＋ in peripheral blood were significantly lower, while CD8 ＋ values in peripheral blood were significantly higher in CHB, LC and HCC groups than those in control group; values of CD3 ＋ , CD4 ＋ and CD4 ＋/ CD8 ＋ in peripheral blood were significantly lower, while CD8 ＋ value was significantly higher in HCC group than those in CHB and LC groups; values of CD3 ＋ , CD4 ＋ and CD4 ＋/ CD8 ＋ in peripheral blood was significantly lower, while CD8 ＋ value was significantly higher in LC group than those in CHB group （P 〈 0.05 ）. Conclusion Abnormal expression of Th in peripheral blood can be found in patients with CHB, LC after hepatitis B infection and HCC after hepatitis B infection, and HCC patients after hepatitis B infection are especially severe.

关 键 词：乙型肝炎 慢性 肝硬化 肝肿瘤 辅助性T淋巴细胞 外周血 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]