慢性HBV感染者外周血可诱导共刺激分子在CD8+ T淋巴细胞的表达及其临床意义  

Expression of ICOS in CD8+T Lymphocytes in Peripheral Blood of Patients with Chronic HBV Infection and Its Clinical Significance

作　　者：陈春林[1] 张华堂[2] 苏密龙[3] 郑怡娟 苏智军[2] 余雪平[2] 任岚 CHEN Chunlin;ZHANG Huatang;SU Milong;ZHENG Yijuan;SU Zhijun;YU Xueping;REN Lan(Department of Infection,Jinjiang Municipal Hospital Shanghai Sixth People's Hospital at Fujian Hospital,Jinjiang,Fujian 362200,China;Department of Infection,Department of Laboratory Medicine,Quanzhou,Fujian 362000,China;Department of Infection,the First Hospital of Quanzhou Affiliated to Fujian Medical University,Quanzhou,Fujian 362000,China)

机构地区：[1]晋江市医院,上海市第六人民医院福建医院感染科,福建晋江362200 [2]福建医科大学附属泉州第一医院感染科,福建泉州362000 [3]福建医科大学附属泉州第一医院检验科,福建泉州362000

出　　处：《转化医学杂志》2024年第2期196-202,共7页Translational Medicine Journal

基　　金：国家自然科学基金资助项目(82370604);福建省自然科学基金资助项目(2023J01239)。

摘　　要：目的 探讨慢性乙型肝炎病毒(HBV)感染者外周血可诱导共刺激分子(ICOS)在CD8+T淋巴细胞的表达特点及临床意义。方法 选取2017年5月—2018年10月就诊的慢性乙型肝炎(CHB)100例、HBV-肝硬化(LC)25例和HBV-慢加急(或亚急)性肝衰竭(ACLF)26例分别纳入CHB组、HBV-LC组和HBV-ACLF组,健康对照(NC)组35例来自同期门诊体检健康者。采用流式细胞仪检测各组ICOS在CD8+T淋巴细胞的表达情况;分析CD8+T淋巴细胞ICOS表达水平与慢性HBV感染者疾病严重程度、HBV-ACLF预后及并发症的相关性;动态观察HBV-ACLF患者治疗过程中CD8+T淋巴细胞ICOS表达变化。结果 HBV-ACLF组外周血CD8+T淋巴细胞ICOS表达比率及平均荧光强度(MFI)均高于CHB组、HBV-LC组和NC组(P<0.05)。慢性HBV感染者ICOS的MFI与白蛋白、胆碱酯酶、总胆固醇、血红蛋白呈负相关(r=-0.263、-0.269、-0.273、-0.302,P=0.003、0.003、0.011、0.004);与直接胆红素、天冬氨酸转氨酶、凝血酶原时间、国际标准化比值呈正相关(r=0.248、0.208、0.331、0.315,P=0.005、0.020、0.003、0.009);与HBV-DNA、腹水及感染无明显相关性(P>0.05)。治疗过程中,HBV-ACLF患者ICOS的MFI无明显改变。但生存组ICOS的MFI在治疗第1周时较治疗前上升(P<0.05)。结论 HBV-ACLF患者外周血CD8+T淋巴细胞ICOS的表达水平明显升高,并与肝脏合成功能、炎症程度及预后相关,治疗早期ICOS水平变化有助于预测慢性HBV感染者的预后。Objective To investigate the expression characteristics and clinical significance of inducible costimulatory molecule(ICOS)in CD8+T lymphocytes in peripheral blood of patients with chronic hepatitis B virus(HBV).Methods From May 2017 to October 2018,100 patients with chronic hepatitis B(CHB),25 patients with HBV-liver cirrhosis(LC)and 26 patients with HBV-acute-on-chronic(or subacute)liver failure(ACLF)were selected and included in the CHB group,HBV-LC group and HBV-ACLF group,respectively.In the healthy control(NC)group,35 people were healthy physical examinees during the same period.The expression of ICOS in CD8+T lymphocytes was detected by flow cytometry.The correlation between ICOS expression level of CD8+T lymphocytes and disease severity,prognosis and complications in patients with chronic HBV infection was analyzed.Changes in ICOS expression of CD8+T lymphocytes in HBV-ACLF patients was dynamically observed during treatment.Results The ICOS expression ratio and mean fluorescence intensity(MFI)of CD8+T lymphocytes in peripheral blood of HBV-ACLF patients were higher than those in CHB,HBV-LC and NC groups(P<0.05).The MFI of ICOS in CD8+T lymphocytes of patients with chronic HBV infection was negatively correlated with albumin,cholinesterase,total cholesterol and hemoglobin(r=-0.263,-0.269,-0.273,-0.302,P=0.003,0.003,0.011,0.004),and positively correlated with direct bilirubin,aspartate aminotransferase,prothrombin time and international standardized ratio(r=0.248,0.208,0.331,0.315,P=0.005,0.020,0.003,0.009);however,it had no significant correlation with HBV-DNA,ascites and infection(P>0.05).During treatment,the MFI of ICOS in CD8+T lymphocyte of HBV-ACLF patients did not change significantly.However,the MFI of ICOS in CD8+T lymphocyte in survival group was higher at the first week of treatment than that before treatment(P<0.05).Conclusion ICOS expression level of CD8+T lymphocytes in peripheral blood of HBV-ACLF patients is significantly increased,and is related to liver synthesis function,inflammation degr

关 键 词：乙型肝炎病毒 乙型肝炎 慢性 肝衰竭 肝硬化 可诱导共刺激因子 CD8+T淋巴细胞 腹水 预后 

分 类 号：R512.62[医药卫生—内科学]