慢性乙型肝炎和重型肝炎患者外周血T淋巴细胞亚群与HBV-DNA、HBeAg的关系

目的 分析慢性乙型肝炎(CHB)和慢性重型乙型肝炎(CSHB)患者T细胞亚群特点,探讨外周血T淋巴细胞亚群变化与乙型肝炎病毒(HBV)复制的关系.方法 使用流式细胞仪检测57名CHB患者及25例CSHB患者外周血T细胞亚群.结果 HBV-DNA(+)CHB组与HBV-DNA(-)CHB组的T细胞亚群比较:HBV-DNA(+)CHB组CD8+T绝对值显著低于HBV-DNA(-)CHB组(P＜0.01),CD4+T/CD8+T比值显著高于HBV-DNA(-)CHB组(P＜0.01).HBV-DNA(+)CSHB组与HBV-DNA(-)CSHB组的T细胞亚群比较:HBV-DNA(+)CSHB组CD8+T绝对值显著高于HBV-DNA(-)CSHB组(P＜O.05); HBV-DNA(+)CSHB组CD4+T/CD8+T比值显著低于HBV-DNA(-)CSHB组(P＜0.01).高HBV-DNA载量-CHB组和低HBV-DNA载量-CHB组的T细胞亚群比较:高HBV-DNA载量-CHB组CD8+T绝对值显著低于低HBV-DNA载量-CHB组(P＜0.05).HBeAg(-)CHB患者HBV-DNA(+)组与HBV-DNA(-)组的T细胞亚群比较:在HBeAg(-)CHB患者中,HBV-DNA(+)组CD8+T绝对值显著低于HBV-DNA(-)组(P＜ 0.05)；HBV-DNA(+)组CD4+T/CD8+T比值显著高干HBV-DNA(-)组(P＜0.05).结论 不同的临床转归患者T细胞亚群状态不同,T细胞亚群紊乱程度和CD8+T绝对值与HBV-DNA载量、HBeAg有关.

Relationship between HBV-DNA replication and T-lymphocyte subsets in peripheral blood of patients with chronic hepatitis B and chronic severe hepatitis B

OBJECTIVE To analyze the T-lymphocyte subsets of patients with chronic hepatitis B(CHB)and with chronic severe hepatitis B(CSHB),to explore the correlation between the T-lymphocyte subsets and HBV-DNA.METHODS T-lymphocyte subsets of 57 patients with chronic hepatitis B(CHB)and 25 patients with chronic severe hepatitis B(CSHB)were detected by flow cytometry(FCM).RESULTS T-lymphocyte subsets of the HBV-DNA(+)CHB group and the HBV-DNA(-)CHB group:CD8+T of HBV-DNA(+)CHB group was significantly lower than the HBV-DNA(-)CHB group(P﹤0.01),CD4+T/CD8+T ratio of HBV-DNA(+)CHB group was significantly higher than the HBV-DNA(-)CHB group(P﹤0.01).T-lymphocyte subsets of the HBV-DNA(+)CSHB group and the HBV-DNA(-)CSHB group:CD8+T of HBV-DNA(+)CSHB group were significantly higher than the HBV-DNA(-)CSHB group(P﹤0.05),CD4+T/CD8+T ratio was significantly lower than HBV-DNA(-)CSHB group(P﹤0.01).T-lymphocyte subsets of the high HBV-DNA loads-CHB group and the low HBV-DNA loads-CHB group:CD8+T of the high HBV-DNA loads-CHB group was significantly lower than the low HBV-DNA loads-CHB group(P﹤0.05).T-lymphocyte subsets of the HBeAg(+)CHB group and the HBeAg(-)CHB group:CD8+T and CD4+T/CD8+T ratio of HBeAg(+)CHB group were significantly lower than the HBeAg(-)CHB group(P﹤0.05 and P﹤0.01).CONCLUSION Patients with different prognosis of chronic HBV-infection have different status of T-lymphocyte subsets.The functional status and the absolute figure of CD8+ in T-lymphocyte subsets have a significant correlation with the HBV-DNA load and HBeAg.