摘要
目的分析乙型肝炎病毒(HBV)复制、转归及变异与细胞免疫功能的关系。方法检测37例慢性乙型肝炎(乙肝)患者(慢性乙肝组)、20例HBV携带者(无症状携带组)、36例乙肝肝硬化患者(乙肝肝硬化组)及24例健康体检者(正常对照组)的外周血T细胞亚群,分析HBV不同感染状况者T细胞亚群的差异;用实时荧光定量PCR法检测HBV感染者HBV-DNA水平和拉米夫定相关变异(YMDD)。结果 (1)与正常对照组比较,无症状携带组和慢性乙肝组的CD3+、CD4+T细胞的百分比和计数均显著降低(P<0.05),无症状携带者的CD8+T细胞计数亦显著低于正常对照组(P<0.05),而两组的CD8+T细胞百分比及CD4+/CD8+比值与正常对照组比较,差异均无统计学意义(P>0.05);乙肝肝硬化组CD4+T细胞百分比与正常对照组比较,差异无统计学意义(P>0.05),但CD4+/CD8+比值显著高于正常对照组,CD3+、CD4+、CD8+T细胞计数均显著低于其他各组,差异有统计学意义(P<0.05)。(2)HVB感染者HBV-DNA水平与外周血CD3+、CD4+、CD8+T细胞及CD4+/CD8+比值无相关性(P>0.05)。(3)抗病毒治疗6个月后HBV-DNA水平小于检测低限组的外周血CD3+、CD4+、CD8+T细胞计数显著高于治疗12个月后转归及无转归组,而CD4+/CD8+比值显著低于治疗12个月后无转归组,差异均有统计学意义(P<0.05)。(4)拉米夫定相关变异型和野生型HBV感染者外周血CD3+、CD4+、CD8+T细胞及CD4+/CD8+比值间差异无统计学意义(P>0.05)。结论慢性HBV感染者体内存在T细胞亚群失衡和细胞免疫功能紊乱,可能是HBV感染后慢性化的重要原因;T细胞亚群检测可作为抗病毒治疗效果和疾病转归的预测指标;T细胞亚群计数较百分比更能反映患者的细胞免疫状况。
Objective To analyze the relationship of hepatitis B virus （HBV） replication, Prognosis, Variation to peripheral blood T lymphocyte subsets. Methods The peripheral blood T - lymphocyte subsets of 37 patients with chronic hepatitis B, 20 HBV carriers, 36 with Hepatitis B cirrhosis and 24 normal human were detected by flow cytometry. HBV - DNA level and Lamivudine - related mutation detected by real - time quantitative PCR in patients with HBV. Results （ 1 ） Compared with normal controls, the number and percentage of CD3^＋ T cells, CD4^＋ T cells in HBV carriers and patients with chronic hepatitis B decreased （ P 〈 0. 05 ） , CD8^＋ T cells of carriers lower than that of control （ P 〈 0. 05 ） , the 2 groups were not significantly different from control in CD8^＋ T cell percentage and CD4^＋/CD8^＋ ratio （P 〉0. 05）. But CD4^＋/CD8^＋ ratio was significantly higher, the other indexes lower than in control group （P 〉0. 05）. （2） HBV - DNA level was not correlated with peripheral CD3^＋ , CD4^＋ , CD8^＋ T cells and CD4^＋/CD8^＋ ratio in HVB infected persons （ P 〉 0. 05 ）. （3） The levels of CO3^＋ T cells, CD4^＋ T cells and CD8^＋ T cells were significantly higher, CD4^＋/CD8^＋ ratio lower in improved group receiving 6 - month antiviral treatment than in unimproved group receiving 12 - month antiviral therapy （ P 〈 0. 05 ）. （4） There was not significant difference in levels of CD3^＋ T cells, CD4^＋ T cells, CD8^＋ T cells and CD4^/CD8^＋ ratio between HBV patients with Lamivudine - related mutation and wild - type （P 〉 0. 05）. Conclusion T lymphocyte subset imbalance and cellular immune dysfunction, existing in chronic HBV patients, may be an important cause for persistent HBV infection. Detection of T cell subsets can be used as a predictor of antivirus effects and disease outcome. The percentage of T cell subsets can reflect patients＇ immune status.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第20期2226-2229,共4页
Chinese General Practice
关键词
肝炎病毒
乙型
病毒复制
肝炎
乙型
慢性
肝硬化
T淋巴细胞
拉米夫定相关变异
Hepatitis B virus
Virus replication
Hepatitis B, chronic
Liver cirrhosis
T-lymphocytes
Lamivu- dine - related mutation
