乙型肝炎患者外周血T淋巴细胞亚群变化及临床意义
T lymphocyte subsets in peripheral blood of hepatitis B patients and its clinical signifi cance
-
摘要: 目的 观察不同类型乙型肝炎病毒 (hepatitis B virus, HBV) 感染者外周血T淋巴细胞亚群变化特点。 方法 对我院2013年6-11月门诊及住院的200例乙肝患者和50例健康对照者采用流式细胞术 (flow cytometry, FCM) 检测外周血淋巴细胞 (CD45+)、T淋巴细胞 (CD45+CD3+、CD45+CD3+CD4+、CD45+CD3+CD8+)、B淋巴细胞 (CD45+CD3-CD19+)、NK淋巴细胞 (CD45+CD3-CD16+56+) 百分比和细胞绝对计数。 结果 急性乙型肝炎组T淋巴细胞总数、CD4+和CD8+T淋巴细胞数较健康对照组显著升高 (P<0.01)。慢性乙型肝炎组、肝硬化组和肝衰竭组:T淋巴细胞总数、CD4+和CD8+T淋巴细胞数、CD4+/CD8+比值均较健康对照组降低, 其中肝衰竭组<肝硬化组<慢性乙型肝炎组。慢性乙型肝炎组CD4+淋巴细胞百分比较健康对照组显著降低 (P<0.01)。肝硬化组CD4+淋巴细胞百分比较慢性乙型肝炎组显著降低 (P<0.01), CD8+T淋巴细胞百分比显著升高 (P<0.01)。肝衰竭组T淋巴细胞和CD4+T淋巴细胞百分比较肝硬化组显著降低 (P<0.01)。 结论 乙型肝炎患者CD4+T淋巴细胞持续降低, 与疾病病程发展密切相关。Abstract: Objective To observe the characteristics of T lymphocyte subsets in peripheral blood of hepatitis B patients. Methods Peripheral T-lymphocytes(CD45+CD3+, CD45+CD3+CD4+, CD45+CD3+CD8+), B-lymphocytes(CD45+CD3-CD19+), NKlymphocytes(CD45+CD3- CD16+56+) in 200 hepatitis B patients who visited our outpatient department in our hospital from June 2013 to November 2013 and in 50 healthy controls were detected by flow cytomentry. Results The total number of T lymphocytes and the number of CD4+ and CD8+T were significantly higher in acute hepatitis B patients than in healthy controls(P<0.01). The total number of T lymphocytes, the number of CD4+ and CD8+ T lymphocytes and the CD4+/CD8+ T lymphocytes ratio were significantly lower in chronic hepatitis B patients, cirrhotic patients and liver failure patients than in healthy controls(P<0.01). The percentage of CD4+ lymphocytes was significantly lower in chronic hepatitis B patients than in healthy controls and in cirrhotic patients than in chronic hepatitis B patients while the CD8+ T lymphocytes ratio was significantly higher in cirrhotic patients than in chronic hepatitis B patients and the T lymphocytes and CD4+ T lymphocytes ratio was significantly lower in liver failure patients than in cirrhotic patients(P<0.01). Conclusion The number of CD4+T lymphocytes and cellular immune function decrease in hepatitis B patients, thus inducing persistent HBV infection. Peripheral T lymphocyte subsets are closely related with the progress of disease.