乙型肝炎病毒基因型不同的患者肝功能相关指标及免疫功能变化分析  

Analysis of liver function and immune function changes in patients with different I-IBV genotypes

作　　者：陈慧[1] 马瑞英[3] 吴敏娟[1] 朱晓燕[1] 徐俊驰 宋华锋[1] 胥萍 

机构地区：[1]苏州市第五人民医院检验中心,215007 [2]苏州市感染免疫重点实验室,215007 [3]苏州大学医学部,215123

出　　处：《国际免疫学杂志》2017年第4期369-374,共6页International Journal of Immunology

基　　金：苏州市科学技术局项目（SYSD2013128）

摘　　要：目的探讨基因型不同的乙肝患者肝功能、病毒载量和免疫功能的差异及临床意义。方法145例乙肝患者划分两个年龄段：小于35岁和大于35岁，全部应用实时荧光PCR法进行乙型肝炎病毒（HBV）基因分型检测；同时采用实时荧光PCR法检测血清HBV-DNA载量；用全自动生化分析仪和流式细胞仪检测各组肝功能相关指标及淋巴细胞亚群含量。结果145例HBV患者仅为两种基因型，B基因型62例（42．76％），C基因型83例（57．24％）。B型患者谷丙转氨酶（ALT）、谷草转氨酶（AST）和HBV-DNA均稍高于C型，分别是[（263．6±36．13）U／L比（243．1±37．69）U／L]、[（128．1±15．84）U／L比（123．6±19．1）U／L]和[（6．131±0．2133）比（5．875±0．1725）]，进行统计学分析后差异均无统计学意义（P〉0．05），但划分年龄段后，大于35岁的患者，B型ALT、AST和HBV-DNA均显著高于C型（P〈0．05），分别是[（227．6±34．52）U／L比（144．8±19．92）U／L]、[（124．5±19．4）U／L比（79．79±12）U／L]和[（6．166±0．2582）比（5．228±0．2644）]。淋巴细胞亚群分析可见，所有年龄段或大于35岁患者均是B型的CD4＋T细胞比例显著低于c型[（32．97±0．95）％比（35．81±0．85）％]（P〈0．05），CD8＋T细胞显著高于c型[（30．19±0．97）％比（27．44±0．92）％]（P〈0．05），而CD3＋T细胞、B细胞、NK细胞在B型和C型患者中则差异无统计学意义（P〉0．05）。结论145例HBV患者B、C型的分布未见显著差异；肝功能、病毒载量及T细胞亚群在年龄较大的B、C两组患者中存在显著差异。Objective To investigate the differences and clinical significance of liver function, viral con- tent and immune function in patients with different hepatitis B virus （HBV）genotypes. Methods 145 patients with hepatitis B were divided into two age groups ： less than 35 years old and more than 35 years old. HBV geno- types of the patients were determined by real - time quantitative PCR （ RT - qPCR）. Meanwhile, the serum HBV - DNA content was detected by RT - qPCR. The indexes of liver function and lymphocyte subsets in each group were detected by automatic biochemical analyzer and flow cytometry. Results 145 patients with HBV in- fection only have two genotypes, B genotype in 62 patients （ 42. 76% ） and C genotype in 83 patients （57.24%）. ALT,AST,and HBV-DNA of the patients with genotype B were slightly higher than that of the pa- tients with genotype C [ （263.6 ± 36.13 ） U/L versus （243.1 ± 37.69 ） U/L for ALT; （ 128.1 ± 15.84） U/L versus （123.6 ± 19.1） U/L for AST;and （6. 131 ± 0.2133） versus （5.875 ± 0. 1725） for HBV DNA content） ]. However, there is no significant difference （ P 〉 0.05 ）. However, signifieant difference was obtained between patients sorted according to their ages （35 year old as the boundary line）. For patients older than 35 years, ALT, AST and HBV - DNA of patients with genotype B were significantly higher than that of patients with genotype C （P〈0.05） [（227.6 ± 34.52） U/L versus （144.8 ±19.92）U/L for ALT;（124.5 ±19.4）U/L versus 79. 79 ± 12） U/L for AST,and（6. 166 ± 0.2582） versus （5. 228 ± 0.2644） for HBV DNA eontent]. The analysis of lymphocyte subsets showed that the ratio of CD4＋ T cell in all patients with genotype B was sig- nificantly lower than that of patients with genotype C[ （32.97 ±0.95）% versus （35.81 ±0.85）% ）P 〈 0. 05 ） ], while the ratio of CD8 ＋T cells was significantly higher in patients with genotype B than that of the pa- tients with genotype C [ （30.19 ± 0.9

关 键 词：乙型肝炎病毒基因型 肝功能 乙型肝炎病毒-DNA 淋巴细胞亚群 

分 类 号：R446.1[医药卫生—诊断学] R512.62[医药卫生—临床医学]