血清腺苷脱氨酶和T细胞亚群在慢性乙型肝炎中的表达水平及临床意义  

Serum adenosine deaminase and T cell subsets of patients with chronic hepatitis B and their clinical significance

作　　者：毛重山[1] 殷辉[1] 肖二辉[1] 康月花 宁会彬 尚佳[1] MAO Chong-shan;YIN Hui;XIAO Er-hui;KANG Yue-hua;NING Hui-bin;SHANG Jia(Henan Peoples Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]河南省人民医院感染性疾病科,河南郑州450000

出　　处：《中华医院感染学杂志》2020年第5期698-702,共5页Chinese Journal of Nosocomiology

基　　金：河南省科研基金资助项目(2799372)。

摘　　要：目的研究乙型肝炎病毒(HBV)感染后不同类型乙型肝炎患者HBV-DNA载量与腺苷脱氨酶(ADA)以及外周血T细胞亚群的表达水平及临床意义.方法选取河南省人民医院2014年1月-2019年1月的慢性HBV携带者、慢性乙型肝炎、慢性乙型肝炎肝硬化患者作为病例组,共126例;同期体检的126名健康人群作为对照组.对比两组的ADA、T细胞亚群、HBV-DNA指标.结果病例组CD3+、CD4+、CD4+/CD8+水平低于对照组,CD8+、ADA水平高于对照组,差异具有统计学意义(P<0.05);慢性HBV携带者CD3+、CD4+及CD4+/CD8+指标高于慢性乙型肝炎和慢性乙型肝炎伴肝硬化患者,但CD8+、ADA、HBV-DNA指标则低于慢性乙型肝炎和慢性乙型肝炎伴肝硬化患者,差异具有统计学意义(P<0.05).慢性乙型肝炎与慢性乙型肝炎肝硬化的HBV-DNA水平则无统计学差异.HBV-DNA含量与细胞免疫功能相关性比较,CD3+、CD4+、CD4+/CD8+与HBV-DNA呈负相关;CD8+、ADA与HBV-DNA呈正相关.结论乙型肝炎患者,HBV感染者存在T淋巴细胞亚群比例异常;ADA水平越高,则预示病情在持续加重,应引起重视.OBJECTIVE To observe the correlation between HBV-DNA load and the levels of adenosine deaminase(ADA) and peripheral blood T cell subsets of the patients with different tupes of hepatitis B after hepatitis B virus(HBV) infection and analyze the clinical significance. METHODS The chronic HBV carriers, patients with chronic hepatitis B and patients with chronic hepatitis B cirrhosis who were treated in Henan People’s Hospital from Jan. 2014 to Jan 2019, 126 cases in total, were chosen as the case group, meanwhile, 126 healthy people who received physical examination were set as the control group. ADA, T cell subsets and HBV-DNA were observed and compared between the two groups. RESULTS The levels of CD3+, CD4+ and CD4+/CD8+ of the case group were lower than those of the control group, the levels of CD8+ and ADA of the case group were higher than those of the control group(P<0.05). The levels of CD3+, CD4+ and CD4+/CD8+ of the chronic HBV carriers were significantly higher than those of the patients with chronic hepatitis B and the chronic hepatitis B patients complicated with liver cirrhosis, however, the levels of CD8+, ADA and HBV-DNA of the chronic HBV carriers were significantly lower than those of the patients with chronic hepatitis B and the chronic hepatitis B patients complicated with liver cirrhosis(P<0.05). There was no significant difference in the HBV-DNA level between the patients with chronic hepatitis B and the chronic hepatitis B patients complicated with liver cirrhosis. The analysis of the correlation between the HBV-DNA level and the cellular immune function showed that the HBV-DNA was positively correlated with CD3+, CD4+ and CD4+/CD8+ and was positively correlated with CD8+ and ADA. CONCLUSION The patients with hepatitis B and the patients with HBV infection have the abnormal percentages of T lymphocytes subsets. The higher the ADA level, the more severer the illness condition is, and it is necessary to attach great importance to.

关 键 词：腺苷脱氨酶 T细胞亚群 乙型肝炎病毒 HBV-DNA 

分 类 号：R512.62[医药卫生—内科学]