慢性乙型肝炎患者不同免疫状态下外周血T淋巴细胞程序性死亡受体1表达与乙型肝炎病毒DNA载量及丙氨酸氨基转移酶水平的相关性  

The relationship among programmed death receptor 1 expression of peripheral blood T lymphocytes, hepatitis B virus DNA load and alanine aminotransferase level in chronic hepatitis B patients under different immune status

作　　者：赵海珍[1] 其其格[1] 刘瑞军[1] 奥敦托亚 Zhao Haizhen;Qiqi Ge;Liu Ruijun;Ao Duntuoya(Department of Infectious Diseases,the Affiliated Hospital of Inner Mongolia Medical University,Huhhot 010050,China)

机构地区：[1]内蒙古医科大学附属医院感染科,呼和浩特市010050

出　　处：《中华实验和临床感染病杂志（电子版）》2018年第6期585-589,共5页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：2017年内蒙古自治区卫生和计划生育委员会科研计划项目(No.201703110)

摘　　要：目的探讨慢性乙型肝炎(CHB)患者不同免疫状态下外周血T淋巴细胞程序性死亡受体1(PD-1)表达与乙型肝炎病毒(HBV)DNA载量及丙氨酸氨基转移酶(ALT)水平的相关性。方法选取2017年1月至2018年3月于内蒙古医科大学附属医院接受治疗的CHB患者118例,依据患者不同免疫状态分成3组,分别为HBV e抗原(HBeAg)阴性组(25例)、免疫活化组(67例)和免疫耐受组(26例);同时选取同期在本院健康体检者50例作为对照组。全自动生化分析仪检测肝功能,ELISA法检测HBV核心抗体(HBcAb)、HBV表面抗原(HBsAg)、HBV e抗体(HBeAb)、HBeAg和HBV表面抗体(HBsAb)含量,荧光定量PCR检测患者HBV DNA载量,流式细胞仪检测血清表达PD-1的CD8+T、CD4+T淋巴细胞含量。结果免疫活化组、HBe Ag阴性组患者血清表达PD-1的CD8+T、CD4+T含量分别为(7.48±1.76)%、(7.48±1.76)%和(10.58±1.95)%、(8.38±1.85)%,均高于对照组[(3.22±1.53)%、(4.05±1.76)%]和免疫耐受组[(4.26±1.89)%、(3.86±1.89)%],差异均有统计学意义(F=12.084、P=0.015,F=13.297、P=0.032);免疫活化组、HBe Ag阴性组患者HBV DNA载量分别为(7.02±1.13)log10拷贝/ml和(5.77±1.25)log10拷贝/ml,低于免疫耐受组患者(8.18±1.08)log10拷贝/ml,差异有统计学意义(F=11.652、P=0.006);免疫活化组、HBe Ag阴性组患者血清ALT、总胆红素含量分别为(193.02±7.39)IU/ml、(50.06±2.18)mmol/L和(179.14±7.62)IU/ml、(43.65±2.27)mmol/L,均高于对照组[(12.71±6.19)IU/ml、(13.07±2.19)mmol/L]和免疫耐受组[(23.19±6.82)IU/ml、(16.54±2.30)mmol/L],差异均有统计学意义(F=10.906、P=0.027,F=9.583、P=0.019);Pearson相关分析显示,免疫耐受组、免疫活化组及HBeAg阴性组患者血清内表达PD-1的CD8+T、CD4+T含量和血清ALT含量无相关性(r=-0.170、0.046、0.068、-0.231、0.048、0.005,P=0.443、0.750、0.761、0.292、0.709、0.912),与血清HBV DNA载量亦无相关性(r=-0.049、0.107、0.104、-0.301、0.019、0.279,P=0.810、0.440、0.681、0.201�Objective To investigate the relationship among the expression of programmed death receptor 1(PD-1)in peripheral blood T lymphocytes in patients with chronic hepatitis B(CHB),hepatitis B virus(HBV)DNA load and the amount of alanine aminotransferase(ALT)level.Methods From January 2017 to March 2018,a total of 118 patients with CHB who were treated in the Affiliated Hospital of Inner Mongolia Medical University were divided into three groups according to different immune status,which were hepatitis B antigen(HBeAg)negative group(25 cases),immune activation group(67 cases)and immune tolerance group(26 cases);while 50 healthy physical examination persons in our hospital were selected as control group.Liver function was detected by automatic biochemical analyzer,HBV core antibody(HBcAb),HBV surface antigen(HBsAg),hepatitis B e antibody(HBeAb),HBeAg and hepatitis B surface antibody(HBsAb)were detected by ELISA,and HBV DNA load was detected by fluorescence quantitative PCR.The expression of PD-1,CD8^+T and CD4^+T lymphocytes in serum were detected by flow cytometry.Results In patients of immune activated group and HBeAg negative group,the expression of PD-1 CD8^+T and CD4^+T lymphocytes in serum were(7.48±1.76)%,(7.48±1.76)%and(10.58±1.95)%,(8.38±1.85)%,respectively,all significantly higher than those of control group[(3.22±1.53)%and(4.05±1.76)%]and immune tolerance group[(4.26±1.89)%and(3.86±1.89)%],with significant differences(F=12.084,P=0.015;F=13.297,P=0.032).The HBV DNA load was(7.02±1.13)log10 copies/ml in immune activation group and(5.77±1.25)log10 copies/ml in HBeAg negative group,significantly lower than that of the immune tolerance group[(8.18±1.08)log10 copies/ml],with significant difference(F=11.652,P=0.006).The levels of serum ALT and total bilirubin in immune activated group and HBeAg negative group were(193.02±7.39)IU/ml,(50.06±2.18)mmol/L and(179.14±7.62)IU/ml,(43.65±2.27)mmol/L,respectively,all signifcantly higher than those of the control group[(12.71±6.19)IU/ml and(13.07±2.19)mmol/L]a

关 键 词：肝炎 乙型 慢性 免疫状态 程序性死亡受体1 丙氨酸氨基转移酶 

分 类 号：R512.62[医药卫生—内科学]