T淋巴细胞亚群、HBsAg、HBeAg评估乙肝患者不同病理状态的临床价值  

The Clinical Value of T Lymphocyte Subsets,HBsAg and HBeAg in Evaluating Different Pathological States of Patients with Hepatitis B

作　　者：康敏荣 周慧芳 金枝 戴雪娥 闫伟 KANG Minrong;ZHOU Huifang;JIN Zhi(Department of Clinical Laboratory,PLA Naval Medical Center,Shanghai 200052)

机构地区：[1]中国人民解放军海军特色医学中心检验科,上海200052

出　　处：《医学临床研究》2025年第2期268-271,共4页Journal of Clinical Research

摘　　要：【目的】探讨T淋巴细胞亚群、乙型肝炎表面抗原(HBsAg)、乙型肝炎e抗原(HBeAg)评估乙肝患者不同病理状态的临床价值。【方法】选择2020年5月至2023年5月本中心收治的85例乙肝患者,病理学检查结果显示,炎症分级<2级48例、炎症分级≥2级37例,纤维化分期<2期36例、纤维化分期≥2期49例。比较不同纤维化分期及炎症分级的乙肝患者HBsAg、HBeAg、T淋巴细胞亚群水平,采用受试者工作特征(ROC)曲线分析HBsAg、HBeAg及T淋巴细胞亚群水平评估乙肝患者不同病理状态的临床价值。【结果】纤维化分期≥2期的患者HBsAg、HBeAg水平明显低于纤维化分期<2期的患者,差异有统计学意义(P<0.05);不同纤维化分期的乙肝患者CD4^(+)、CD8^(+)水平比较,差异无统计学意义(P>0.05)。ROC曲线分析显示,HBsAg、HBeAg水平预测纤维化分期≥2期的临床效能较好,曲线下面积分别为0.772、0.821(P<0.05)。炎症分级≥2级的患者HBsAg、HBeAg、CD8^(+)水平明显低于炎症分级<2级的患者,CD4^(+)水平明显高于炎症分级<2级的患者,差异有统计学意义(P<0.05)。ROC曲线分析显示,HBsAg、HBeAg、CD4^(+)、CD8^(+)水平预测炎症分级≥2级的临床效能较好,曲线下面积为0.785、0.808、0.644、0.683,差异有统计学意义(P<0.05)。【结论】不同病理状态下乙肝患者的HBsAg、HBeAg水平及免疫功能存在异常,临床可联合检测HBsAg、HBeAg及T淋巴细胞亚群水平,可更好地评估患者疾病进展情况。【Objective】To investigate the clinical value of T lymphocyte subsets,hepatitis B surface antigen(HBsAg)and hepatitis Be antigen(HBeAg)in evaluating different pathological states of patients with hepatitis B.【Methods】A total of 85 cases of hepatitis B patients admitted to our hospital from May 2020 to May 2023 were selected.Pathological examination results showed that 48 cases had inflammation grade<2,of which 37 cases had inflammation grade≥2,of which 36 cases had fibrosis stage<2,and 49 cases had fibrosis stage≥2.The levels of HBsAg,HBeAg and T lymphocyte subsets in patients with different fibrosis stages and inflammatory grades were compared,and the clinical value of HBsAg,HBeAg and T lymphocyte subsets were analyzed by receiver operating characteristic(ROC)curve to evaluate the different pathological status of hepatitis B patients.【Results】The levels of HBsAg and HBeAg in patients with fibrosis stage≥2 were significantly lower than those with fibrosis stage<2,the difference was statistically significant(P<0.05).There was no significant difference in CD4^(+)and CD8^(+)levels among hepatitis B patients with different fibrosis stages(P>0.05).ROC curve analysis showed that HBsAg and HBeAg levels had better clinical efficacy in predicting fibrosis stage≥2,and the area under the curve were 0.772 and 0.821,respectively(P<0.05).HBsAg,HBeAg and CD8^(+)levels in patients with inflammation grade≥2 were significantly lower than those with inflammation grade<2,and CD4^(+)levels were significantly higher than those with inflammation grade<2,with statistical significance(P<0.05).ROC curve analysis showed that HBsAg,HBeAg,CD4^(+),CD8^(+)levels had better clinical efficacy in predicting inflammation grade≥2,and the area under the curve was 0.785,0.808,0.644,0.683,with statistical significance(P<0.05).【Conclusion】HBsAg and HBeAg levels and immune function are abnormal in patients with hepatitis B in different pathological states,and the levels of HBsAg,HBeAg and T lymphocyte subsets can be jointly de

关 键 词：乙型肝炎 T淋巴细胞亚群 乙型肝炎表面抗原 乙型肝炎E抗原 

分 类 号：R512.62[医药卫生—内科学]