慢性乙型肝炎患者外周血CD8^+CD28^+T淋巴细胞百分比的变化及其临床意义探讨  

Changes of peripheral blood CD8^+CD28^+T lymphocyte percentages in patients with hepatitis B

作　　者：周积云 马勇[1] 丁体龙[1] 涂远航[1] 陈策[1] Zhou Jiyun;Ma Yong;Ding Tilong(Liver Centre,902rd Hospital of PLA,Bengbu Medical College,Bengbu 233015, Anhui Province,China)

机构地区：[1]蚌埠医学院教学医院/解放军联勤保障部队第902医院肝病中心,安徽省蚌埠市233015

出　　处：《实用肝脏病杂志》2019年第2期180-183,共4页Journal of Practical Hepatology

摘　　要：目的探讨不同病程阶段的慢性乙型肝炎患者外周血CD8^+CD28^+T淋巴细胞百分比的变化,以及CD8^+CD28^+T淋巴细胞百分比变化与血清HBsAg水平的关系。方法 2018年4月～2018年8月我院诊治的慢性乙型肝炎患者88例,其中免疫耐受期20例,免疫清除期28例,非活动期20例,再活动期20例,另选择健康人20例。使用流式细胞术检测外周血CD8^+CD28^+T淋巴细胞百分比。结果健康人与免疫耐受期患者外周血CD8^+CD28^+T淋巴细胞百分比分别为(26.1±3.5)%和(26.3±3.4)%,差异无统计学意义(P>0.05);免疫清除期患者CD8^+CD28^+T淋巴细胞百分比为(40.1±4.7)%,显著高于健康人(P<0.05);非活动期和再活动期患者外周血CD8^+CD28^+T淋巴细胞百分比分别为(20.3±2.2)%和(26.1±2.2)%,显著低于健康人(P<0.05);外周血HBsAg低、中、高三组人群外周血CD8^+CD28^+T淋巴细胞百分比分别为(24.0±7.5)%、(28.4±8.9)%和(33.2±8.5)%,各组间差异有统计学意义(P<0.05)。结论不同病程阶段的慢性乙型肝炎患者外周血CD8^+CD28^+T淋巴细胞百分比存在明显差异,可能与病毒长期刺激机体免疫系统,导致免疫系统功能失调有关,而这种失调可能参与了慢性乙型肝炎的发病过程。Objective To investigate the changes of peripheral blood CD8^+CD28^+T lymphocyte percentages in patients with hepatitis B.Methods A total of 88 patients with hepatitis B and 20 healthy individuals were recruited in 902nd hospital of PLA between April 2018 and August 2018,and the patients with hepatitis B included patients in immune tolerance phase(n=20),immune clearance phase(n=28),low replication phase(n=20),and re-activation phase(n=20).The percentages of CD8^+CD28^+T lymphocytes in peripheral blood were measured by flow cytometry.Results The percentages of CD8^+CD28^+T lymphocytes in patients in immune tolerance phase were(26.3±3.4)%,not significantly different as compared to(26.1±3.5)%in healthy persons(P>0.05);the percentages of CD8^+CD28^+T lymphocytes in patients in immune clearance were(40.1±4.7)%,significantly higher than that in healthy control(P<0.05);the percentages of CD8^+CD28^+T lymphocytes in patients inactive phase and reactive stage were(20.3±2.2)%and(26.1±2.2)%,respectively,significantly lower than that in healthy control(P<0.05);the CD8^+CD28^+T lymphocytes in patients with high,moderate and low serum HBsAg level were(24.0±7.5)%,(28.4±8.9)%and(33.2±8.5)%,respectively,with statistically significant differences among them(P<0.05).Conclusions There are significant differences in the percentages of peripheral blood CD8^+CD28^+T lymphocytes in patients with hepatitis B at different immune phases,which might be related to the dysfunctions of immune system activated by the viral infection.

关 键 词：慢性乙型肝炎 免疫分期 乙型肝炎病毒表面抗原 CD8^+CD28^+T淋巴细胞 

分 类 号：R512.62[医药卫生—内科学]