CD4^+CD25^+调节性T细胞在HBV感染相关性血小板减少患者外周血中的比例和意义  

Proportion and significance of CD4^+CD25^+ regulatory T cells in peripheral blood of patients with hepatitis B virus infection related thrombocytopenia

作　　者：蒋端凤 莫秋玉 林文远[1] 张国珍 周琴[1] 陶利英[1] 何玉婵[1] 董敏[1] JIANG Duan-Feng;MO Qiu-Yu;LIN Wen-Yuan;ZHANG Guo-Zhen;ZHOU Qin;TAO Li-Ying;HE Yu-Chan;DONG Min(Department of Hematology of Affiliated Hospital of Guilin Medical College,Guilin 541001,China)

机构地区：[1]桂林医学院附属医院血液科

出　　处：《中国免疫学杂志》2019年第20期2522-2526,共5页Chinese Journal of Immunology

基　　金：广西高校中青年教师基础能力提升项目(KY2016YB309);北京医卫健康公益基金资助项目(YWJKJJHKYJJ-B17485);广西中青年教师基础能力提升项目(2018KY0404);广西国家级大学生创新创业训练计划项目(201610601029);广西中青年教师基础能力提升项目(KY2016YB318);广西卫计委自筹课题(Z2016044)

摘　　要：目的:探讨乙型肝炎病毒(HBV)感染相关性血小板减少患者外周血中CD4^+CD25^+调节性T细胞(Tregs)的比例及其临床意义。方法:本院2016年11月至2017年11月收治的34例患者,其中HBV感染相关性血小板减少患者12例为实验组,免疫性血小板减少(ITP)患者12例为ITP组,慢性乙型肝炎患者10例为HBV感染组;选择同期门诊健康体检者10例为正常对照组。应用流式细胞仪检测各组患者外周血中CD4^+、CD4^+CD25^+及CD4^+CD25^+/CD4^+比例,并对实验组患者外周血CD4^+CD25^+T细胞比例与HBV DNA定量、血小板计数进行相关性分析。结果:与HBV感染组比较,实验组CD4^+CD25^+T细胞比例降低[(4.05±3.70)%比(5.36±1.64)%,U=30.0,P=0.048],CD4^+比例降低[(24.64±9.80)%比(38.42±7.70)%,U=16.0,P=0.004]。与正常对照组比较,HBV感染组CD4^+CD25^+T细胞比例增高[(5.36±1.64)%与(3.61±1.20)%,U=20.0,P=0.023];实验组CD4^+CD25^+T细胞比例与健康对照组、ITP组均无明显差异(P>0.05)。实验组CD4^+CD25^+Treg细胞比例与血小板计数存在负相关关系,但差异无明显统计学意义(r=-0.511,P=0.089);而与HBV DNA水平无明显相关性(r=0.167,P=0.603)。结论:CD4^+CD25^+调节性T细胞表达可能受乙肝病毒感染相关免疫耐受与ITP相关免疫调节异常共同的影响。Objective:To evaluate the proportion and significance of CD4^+CD5^+ regulatory T cells(Tregs) in patients with hepatitis B virus and immune thrombocytopenia.Methods: Peripheral blood mononuclear cells of 12 patients with hepatitis B virus infection related thrombocytopenia as experimental group,12 patients with ITP,10 patients with hepatitis B virus infection and 10 healthy donors as control group.Flow cytometry was used to evaluate the proportion of CD4^+T cells,CD4^+CD25^+T cells,and CD4^+CD25^+/CD4^+.The correlation between the CD4^+CD25^+ proportion and HBV DNA and platelet counts in the experimental group were analyzed.Results: The peripheral blood CD4^+CD25^+ regulatory T cells of HBV infection group was significantly different from the experimental group in the rate [(4.05±3.70)% vs(5.36±1.64)%,U=30.0,P=0.048],and the CD4^+ T cells in the rate [(24.64±9.80)% vs(38.42±7.70)%,U=16.0,P=0.004].Compared with the normal control group,HBV infections group had a significant increase in the proportion of CD4^+CD25^+Treg [(5.36±1.64)% vs(3.61±1.20)%,U=20.0,P=0.023],while the experimental group and ITP group had no difference.In experimental group,there was a negative correlation between Treg cell proportions and platelet count,but with no statistical significance(r=-0.511,P=0.089);Treg cell proportions had no correlation with HBV-DNA level(r=0.167,P=0.603).Conclusion: The expression of CD4^+CD25^+ regulatory T cells may be affected by the common effects of HBV infection related immune tolerance and ITP related immunoregulatory abnormality.

关 键 词：调节性T细胞 乙型肝炎病毒感染 免疫性血小板减少症 免疫调节 

分 类 号：R558[医药卫生—血液循环系统疾病]