慢性HBV感染及其相关肝病患者外周血T细胞亚群的变化

王慰; 郑欢伟; 任桂芳; 冯爱东; 刘莲; 李兵顺

慢性HBV感染及其相关肝病患者外周血T细胞亚群的变化

石家庄市第五医院感染二科

基金项目:

河北省卫生厅科研基金项目(20090607)；

详细信息

中图分类号: R512.62
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出版历程
- 出版日期: 2013-04-20

Differential profiles of T-cell subsets are present in peripheral blood of patients with various progressive forms of hepatitis B infection

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摘要

摘要:
目的观察不同临床类型HBV感染者外周血T淋巴细胞亚群的差异,探讨HBV对人体T细胞免疫的影响及其可能机制,不同类型慢性HBV感染者免疫失衡的规律。方法用流式细胞仪技术检测患者外周血T细胞亚群。慢性HBV感染者318例,其中HBV携带者8例,慢性乙型肝炎231例,肝炎后肝硬化61例,原发性肝癌18例,观察患者的T淋巴细胞亚群、HBV DNA等。同时收集22名健康志愿者的新鲜血检测T淋巴细胞亚群。结果不同临床类型HBV感染者外周血CD3+T、CD4+T、CD8+T细胞百分数低于正常对照组,差别均有统计学意义（P<0.05或P<0.01）,cd4+ p="">0.05）。结论慢性HBV感染随着病情进展,由慢性肝炎→肝硬化→肝癌,直至细胞免疫功能逐渐衰退。慢性HBV感染的不同阶段的细胞免疫紊乱各具特点,就不同类型患者应采用不同的免疫调节治疗手段。
- 肝炎病毒,乙型 /
- T淋巴细胞亚群
Abstract:
Objective To determine whether various progressive forms of hepatitis B virus (HBV) infection, from HBV carriers to chronic hepatitis B (CHB) without complication or with cirrhosis or hepatocellular carcinoma (HCC) , are associated with differential profiles of T lymphocyte subsets in peripheral blood.Methods Between 2009 and 2011, 318 HBV infections presented for treatment at our hospital, including eight HBV carriers, 231 cases of CHB, 61 cases of CHB-related cirrhosis, and 18 cases of CHB-related HCC.Peripheral blood samples were collected from each patient, as well as from 22 non-HBV infected individuals (to serve as healthy controls) .The various T lymphocyte subsets (CD3+, CD4+, and CD8+) were detected by flow cytometry and expressed as percentages of the entire T lymphocyte cell population.HBV DNA presence and quantity was assessed by fluorescence real-time polymerase chain reaction.Differences between groups were assessed by the Kruskal-Wallis H test.Pairwise comparisons were made by Dunnett's test and multiple comparisons were made by the least significant difference test.Results Compared to the healthy control group, all four of the HBV-infected groups showed significantly less peripheral blood T cell percentages of CD3+ (all, P<0.01) and CD4+ (all, P<0.01) ;however, only the HBV-infected groups of HBV-related cirrhosis and HCC showed significantly less percentages of CD8+ (P<0.05) .none="" of="" the="" hbv-infected="" groups="" showed="" a="" significantly="" different="" ratio="" from="" that="" detected="" in="" healthy="" control="" group="" p="">0.05) .There was a general trend in decreasing percentages of the peripheral blood T cell subsets that followed increases in hepatitis disease progression (HBV carriers>CHB>HBV-related cirrhosis>HBV-related HCC) .Conclusion Progression of the HBV infection to more severe forms of liver disease is accompanied by ebbs in the CD3+, CD4+, and CD8+ T cell subsets.Significantly differential profiles of immunomodulatory cell types may represent useful targets of novel therapeutic strategies tailored to the various progressive forms of CHB.
- hepatitis B /
- T lymphocyte subsets

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