慢性乙型肝炎病毒感染者外周血T细胞亚群变化与其血清HBV DNA的水平分析

目的:观察慢性乙型肝炎病毒(HBV)感染者细胞免疫功能的变化,探讨病毒复制程度与细胞免疫功能的关系。方法:应用流式细胞仪直接免疫荧光法检测136例乙肝病毒感染者、60例正常对照者外周血T淋巴细胞亚群百分率,用荧光定量聚合酶链式反应(PCR)法检测乙型肝炎感染者血清HBV DNA。结果:84例慢性HBV携带者(ASC)、52例慢性乙型肝炎(CHB)患者与健康对照组相比,CD3+ T淋巴细胞百分比、CD4+T淋巴细胞百分比和CD4+/CD8+ T淋巴细胞比值均显著降低(P<0.001),CD8+ T淋巴细胞百分比均显著升高(P<0.001)。慢性乙型肝炎患者与慢性HBV携带者相比,CD3+ T淋巴细胞百分比差异无统计学意义(P>0.05)、CD4+ T淋巴细胞百分比明显降低(P<0.05)、CD8+ T淋巴细胞百分比明显升高(P=0.01)、CD4+/CD8+ T淋巴细胞比值明显降低(P<0.05)。随着病情发展,从健康对照组、慢性HBV携带者到慢性乙型肝炎,CD4+T淋巴细胞百分比、CD4+/CD8+比值呈逐渐下降趋势,CD8+ T细胞百分比呈逐渐升高的趋势。慢性HBV携带者HBV DNA阳性组与HBV DNA阴性组相比,CD3+ T淋巴细胞差异均无统计学意义(P>0.05),CD4+ T淋巴细胞百分比明显下降(P<0.001),CD4+/CD8+ T淋巴细胞比值明显下降(P<0.001),CD8+ T淋巴细胞百分比明显升高(P<0.01)。结论:HBV感染可导致感染者细胞免疫功能的改变,HBA DNA复制增加进一步加重乙肝病毒感染者T细胞亚群的紊乱,CD4+/CD8+ T淋巴细胞比值的动态变化可及时提示临床HBV感染者细胞免疫功能的变化并加强临床的监测。

Relation of peripherol T-cell subsets variation and HBV-DNA levels in chronic heptatitis B-virus infected subjects

Objective:To investigate the significance relation of serum heptatitis B virus(HBV) DNA levels and cellular immunity in chronic heptatitis B virus infection.Methods:Peripheral T-cell subsets were examined in 136 chronic heptatitis B-virus and 60 health control,and HBV DNA in heptatitis B virus was examined by realtime fluores-cence quantitative polymerase chain reaction.Results:In comparison with those in health controls,the rates of CD3+T,CD4+T lymphocyte cells and CD4+T/CD8+T were significantly reduced(P<0.001).and the rates of CD8+T lymphocyte cells was obvious increased(P<0.001)in 84 asymptomatic chronic HBV carriers(ASC) and 52 patients with chronic heptatitis B-virus(CHB) respectively.The rates of CD4+T lymphocyte cells and CD4+T/CD8+T were obvious lower(P<0.05),and the rates of CD8+T lymphocyte cells was obvious higher(P=0.01) in CHB patients than those in ASC patients,but there was no statistically difference for CD3+T lymphocyte cells between them.There was a trend of decreasing the rates of CD4+T cells and CD4+/CD8+ and a trend of increasing of the rate of CD8+T cells in the order of health control and ASC and CHB.The rates of CD3+T lymphocyte cells in ASC patients in HBV DNA positive group showed no significant differences from those of HBVDNA negative group(P>0.05).The rates of CD4+T lymphocyte cell,CD4+/CD8+ were significantly lower(P<0.001),CD8+T lymphocyte cell was significantly higher(P<0.01) in HBV DNA positive group as compared with HBV DNA negative group.Conclusion:Chronic HBV infection can lead to disorder of cellular immunity,and disorder can be promoted by the increased serum levels of HBV DNA.The dynamic changes of CD4+/CD8+ can indicate the changeable cellular immune functions of HBV infections and improve the clinical inspections.