肝脏浸润中细胞毒T淋巴细胞在慢性乙型肝炎中的作用机制研究  

The mechanism of cytotoxic T lymphocytes in liver infiltration of chronic hepatitis B

作　　者：易金萍[1] 陈小文[1] 陈开森[1] 黄自坤[1] 秦奇伟[1] Yi Jinping;Chen Xiaowen;Chen Kaisen(The First Affiliated Hospital of Nanchang University,Nanchang,Jiangxi330006)

机构地区：[1]南昌大学第一附属医院,江西南昌330006

出　　处：《基层医学论坛》2020年第16期2251-2252,共2页The Medical Forum

摘　　要：目的探讨肝脏浸润中细胞毒T淋巴细胞在慢性乙型肝炎中的作用机制。方法收集2016年1月—2017年1月收治的慢性乙型肝炎患者1 000例,依据《慢性乙型肝炎防治指南》中分期标准将其分为慢性肝炎活动期组(475例)和免疫清除期组(525例);另收集同期到我院行健康体检的健康者500例作为对照组。比较3组CD4+T细胞、CD8+T细胞、Treg水平,分析CD4+T细胞、CD8+T细胞、Treg与慢性乙型肝炎的相关性。结果慢性肝炎活动期组CD4+T细胞水平最低,CD8+T细胞、Treg水平最高,其次是免疫清除期组,差异具有统计学意义(P<0.05);CD4+T细胞水平与慢性乙型肝炎病情呈负相关(P<0.05),CD8+T细胞、Treg水平与慢性乙型肝炎病情呈正相关(P<0.05)。结论肝脏浸润中细胞毒T淋巴细胞在慢性乙型肝炎病情进展中具有重要作用,CD4+T细胞、CD8+T细胞可促进纤维化形成,而Treg通过负反馈调节机制,减少肝损伤的同时阻碍乙型肝炎病毒清除。Objective To investigate the mechanism of cytotoxic T lymphocytes in liver infiltration in chronic hepatitis B.Methods 1000 patients with chronic hepatitis B from January 2016 to January 2017 were selected as subjects.According to the staging criteria in the Guidelines for Prevention and Treatment of Chronic Hepatitis B,all selected cases were divided into chronic active hepatitis phase group(475 cases)and immune clearance phase group(525 cases);And 500 healthy people with physical examination in the hospital were selected as control group.The levels of CD4+T cell,CD8+T cell,Treg in three groups were detected and compared among three groups.The correlation of CD4+T cell and CD8+T cell with chronic hepatitis B was analyzed.Results Among three groups,the level of CD4+T cell in chronic active hepatitis phase group was the lowest,and the levels of CD8+T cell and Treg in chronic active hepatitis phase group were the highest,followed by immune clearance phase group,the level of CD4+T cell in control group was the highest,and the levels of CD8+T cell and Treg in control group were the lowest(P<0.05);Pearson correlation analysis showed that the level of CD4+T cell had negative correlation with the severity of chronic hepatitis B(P<0.05),and the levels of CD8+T cell and Treg had positive correlation with the severity of chronic hepatitis B(P<0.05).Conclusion The cytotoxic T lymphocytes in liver infiltration play an important role in the progression of chronic hepatitis B.CD4+T cell and CD8+T cell can promote the formation of fibrosis,while Treg can reduce liver damage and prevent clearance of hepatitis B virus by negative feedback regulation.

关 键 词：慢性乙型肝炎 肝脏浸润 细胞毒T淋巴细胞 作用机制 

分 类 号：R512.62[医药卫生—内科学]