HBV多聚酶基因P区单位点和多位点突变、低中高HBV DNA载量、轻中重度的CHB患者外周血T淋巴细胞亚群观察  

Alterations of peripheral blood T lymphocyte subsets in CHB patients with single-point and multi-point mutations in P region of HBV polymerase gene,low,medium,and high HBV DNA load,or mild,moderate and severe conditions

作　　者：杨莉[1] 侯军良[1] 冯爱东[1] 刘腾飞[1] 许怡[1] YANG Li;HOU Junliang;FENG Aidong;LIU Tengfei;XU Yi(Department of Clinical Laboratory,The Fifth Hospital of Shijiazhuang City,Shijiazhuang 050021,China)

机构地区：[1]石家庄市第五医院检验科,石家庄050021

出　　处：《山东医药》2021年第36期28-31,共4页Shandong Medical Journal

基　　金：河北省医学科学研究重点课题计划(20160784)。

摘　　要：目的观察乙型肝炎病毒(HBV)多聚酶基因逆转录保守区(P区)单位点和多位点突变、低中高HBV DNA载量、轻中重度的慢性乙型肝炎(CHB)患者外周血T淋巴细胞亚群变化。方法CHB患者61例,采用基因测序确认HBV多聚酶基因P区位点突变,另取30例健康人群作对照,比较CHB患者HBV多聚酶基因P区位点突变前后及对照组CD3^(+)、CD4^(+)、CD8;T淋巴细胞变化。61例CHB患者又根据发生P区耐药基因突变的位点个数分为单位点者(29例)和多位点者(32例),根据HBV DNA载量分为低拷贝者(6例)、中拷贝者(22例)、高拷贝者(33例),根据病情程度分为轻度者(12例)、中度者(25例)、重度者(24例),比较其外周血CD3^(+)、CD4^(+)、CD8;T淋巴细胞变化。结果与健康人群比较,CHB患者发生HBV耐药基因突变后CD3^(+)、CD4^(+)、CD8;T淋巴细胞均降低(P均<0.05);与突变前比较,CHB患者突变后CD3^(+)、CD4^(+)T淋巴细胞降低(P均<0.05)。不同位点CHB患者CD3^(+)、CD4^(+)、CD8;T淋巴细胞比较均无显著性差异(P均>0.05)。不同HBV DNA载量CHB患者CD3^(+)、CD4^(+)、CD8;T淋巴细胞比较均无统计学差异(P均>0.05)。与中度者比较,重度者CD3^(+)、CD8;T淋巴细胞降低(P均<0.05)。结论CHB患者体内病毒发生耐药基因突变后,外周血CD3^(+)、CD4^(+)T淋巴细胞消耗增多;随耐药基因突变位点增多,HBV DNA载量不断增高,患者CD3^(+)、CD4^(+)、CD8;T淋巴细胞均呈消耗增多趋势。随病情加重,患者CD3^(+)、CD4^(+)T淋巴细胞消耗不断增多,尤其病情严重期,患者CD8;T淋巴细胞消耗亦增多。Objective To observe the alterations of peripheral blood T lymphocyte subsets in chronic hepatitis B patients with different mutations in P region of hepatitis B virus(HBV)polymerase gene,HBV DNA load,and disease conditions.Methods We selected 61 patients with chronic hepatitis B.Gene sequencing was used to confirm the mutations in the P region of the HBV polymerase gene,and another 30 healthy people were taken as controls.We compared the changes of CD3^(+),CD4^(+),and CD8;T lymphocytes between patients with chronic hepatitis B before and after the mutations in the P region of the HBV polymerase gene and the controls.According to the number of resistant gene mutation sites in P region,they were divided into the single-point group(29 cases)and multi-point group(32 cases);according to HBV DNA loads,they were divided into the low-copy group(6 cases),medium-copy group(22 cases),and high-copy group(33 cases);according to the degree of disease,they were divided into the mild group(12 cases),moderate group(25 cases),and severe group(24 cases).The changes in expression levels of CD3^(+),CD4^(+)and CD8;in peripheral blood were compared.Results After HBV resistance gene mutation,the expression levels of CD3^(+),CD4^(+)and CD8;T lymphocytes decreased in CHB patients(all P<0.05),and the expression levels of CD3^(+)and CD4^(+)T lymphocytes in CHB patients were significantly lower than those before mutation(both P<0.05).There were no significant differences in the expression levels of CD3^(+),CD4^(+)or CD8;T lymphocytes in CHB patients at different loci(all P>0.05).There were no significant differences in the expression levels of CD3^(+),CD4^(+)or CD8;T lymphocytes in CHB patients with different HBV DNA load(all P>0.05).Compared with moderate patients,the severe patients had lower CD3^(+)and CD8;T lymphocytes(both P<0.05).Conclusions The consumption of CD3^(+)and CD4^(+)T lymphocytes in peripheral blood of CHB patients with drug resistance gene mutation increases.With the increase of resistant gene mutation sites,HBV DNA load

关 键 词：慢性乙型肝炎 病毒载量 P区耐药基因 T淋巴细胞 拉米夫定 

分 类 号：R512.6[医药卫生—内科学]