慢性乙型肝炎患者外周血TRECs与CD45+T淋巴细胞亚群检测的临床意义  

Clinical significance of TRECs and CD45+T lymphocyte subsets in peripheral blood of patients with chronic hepatitis B

作　　者：王琛 张永乐[2] 潘克女 吕铁锋 WANG Chen;ZHANG Yongle;PAN Kenv;LV Tiefeng(Department of Hepatology,Hangzhou XIXI Hospital,Hangzhou 310023,China;Clinical Laboratory,Tongde Hos-pital of Zhejiang Province,Hangzhou 310012,China)

机构地区：[1]杭州市西溪医院肝病科,浙江杭州310023 [2]浙江省立同德医院检验科,浙江杭州310012

出　　处：《中国现代医生》2018年第23期8-11,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划(2017KY279)

摘　　要：目的探讨慢性乙型肝炎患者外周血中T细胞受体重排删除环(TRECs)含量以及CD4^+CD45RA^+、CD4^+CD45RO^+、CD8^+CD45RA^+、CD8^+CD45RO^+T淋巴细胞亚群表达的临床意义。方法流式细胞技术与实时荧光定量PCR技术分别检测32例轻度慢乙肝患者、42例中度慢乙肝患者、38例重度慢乙肝患者以及30例健康对照人群外周血中TRECs的含量以及CD4^+CD45RA^+、CD4^+CD45RO^+、CD8^+CD45RA^+、CD8^+CD45RO^+T淋巴细胞亚群表达。结果慢性乙型肝炎患者中轻、中、重组以及健康对照组间相比CD3^+/CD4^+/CD8^+、CD4^+CD45RA^+、CD4^+CD45RO^+变化均无明显差异(P>0.05);CD8^+CD45RA^+均有不同程度的下降,尤其在重度组中下降最为明显,具有统计学差异(P<0.05),CD8^+CD45RO^+存在明显的升高,同样在重度组中升高最为显著具有统计学差异(P<0.05);TRECs含量慢乙肝组较正常对照组明显降低(P<0.05);在慢性乙型肝炎患者中轻、中、重慢乙肝组间TRECs含量也存在统计学差异(P<0.05)。结论 TRECS是胸腺近期输出功能指标,能够反映慢性乙型肝炎近期免疫功能,外周血TRECS与CD45^+T淋巴细胞亚群联合检测较常规CD4^+和CD8^+T淋巴细胞亚群更能全面了解慢性乙型肝炎的进展及预后。Objective To investigate the content of T cell receptor rearrangement（TRECs） and the expression of CD4＋ CD45RA＋, CD4＋CD45RO＋, CD8＋CD45RA＋, CD8＋CD45RO＋T lymphocyte subsets in peripheral blood of patients with chronic hepatitis B. Methods The content of TRECs and the expression of CD4＋CD45RA＋, CD4＋CD45RO＋, CD8 ＋ CD45RA＋, CD8＋CD45ROCF lymphocyte subsets in peripheral blood of 32 patients with mild chronic hepatitis B, 42 patients with moderate chronic hepatitis B, 38 patients with severe chronic hepatitis B and 30 healthy controls were de- tected by real-time fluorescence quantitative PCR and flow cytometry. Results There was no significant difference in CD3 ＋/CD4 7CD8＋, CD4 ＋CD45RA ＋, CD4 ＋CD45RO ＋T lymphocyte subsets between mild, moderate, recombinant and healthy controls in patients with chronic hepatitis B（P〉0.05）; CDS＋CD45RA＋T lymphocyte subsets decreased in all groups, especially in the severe group, and the difference was statistically significant（P〈0.05）; CD8＋CD45RO＋T lympho- cyte subsets were significantly increased in all groups, the most significant increase in the severe group was statistically significant（P〈O.05）; Compared with the normal control group, the content of TRECs in the chronic hepatitis B group was significantly decreased（P〈0.05）; There was also a significant difference in TRECs content between mild, moderate and severe hepatitis B groups （P〈O.05）. Conclusion TRECs is a short-term output function of thymus, can respond to the recent immune function of chronic hepatitis B.Compared with conventional CD4＋ and CD8＋T lymphocyte subsets, TRECs and CD45＋T lymphocyte subsets were able to fully understand the progression and prognosis of chronic hepatitis B.

关 键 词：T细胞受体重排删除环 CD45 慢性乙型肝炎 实时荧光定量PCR 流式细胞技术 

分 类 号：R512.62[医药卫生—内科学]