慢性乙型肝炎患者ALT水平与HBV特异性CTL、非特异性CTL计数的关系

目的 探讨慢性乙型肝炎(CHB)患者丙氨酸转氦酶(ALT)水平与乙型肝炎病毒(HBV)特异性细胞毒性T淋巴细胞(CTL)、非特异性CTL的关系.方法 148例CHB患者根据ALT水平分为3组:甲组35例,ALT≥2×正常值上限(ULN)-5×ULN(100～250 IU/L);乙组53例,ALT＞5×ULN～≤10×ULN(251～500 IU/L);丙组60例,ALT＞10×ULN(＞500 IU/L),用流式细胞仪检测非特异性CTL,对其中74例(甲组17例,乙组27例,丙组30例)人白细胞抗原(HLA)-A2阳性CHB患者检测HBV特异性CTL.比较三组的HBV特异性CTL、非特异性CTL、HBV DNA水平和HBeAg阳性率.结果 HBV特异性CTL:甲组(0.42±0.10)%]高于乙组(0.25±0.08)%],t=6.37,P＜0.01,乙组高于丙组(0.17±0.004)%]t=5.14,P＜0.01.非特异性CTL:甲组(15.01±3.01)%]低于乙组(18.1±5.02)%],t=2.81,P＜0.01,乙组低于丙组(21.5±6.11)%]t=3.07,P＜0.01.HBV DNA水平:甲组(4.97±0.86)log10拷贝/m1]低于乙组(5.92±0.92)log10拷贝/ml],t=4.87,P＜0.01,乙组低于丙组(6.37±0.71)log10拷贝/ml]t=2.92,P＜0.01.HBeAg阳性:甲组15例(42.86%),低于乙组(32例,占60.38%),x2=2.59,P＞0.05,乙组低于丙组(41例,占68.33%),x2=0.788,P＞0.05,甲组低于丙组x2=5.929,P＜0.05.结论 CHB患者非特异性CTL越高,ALT水平越高1],而HBV特异性CTL越低,HBV复制越强.

Relations between ALT level and count of EIBV special CTL and non-specific CTL in patients with chronic hepatitis B

Objective To explore relations between ALT level and hepatitis B virus(HBV)specific CTL and non-specific CTL in patients with chronic hepatitis B(CHB).Methods 148 cases of CHB were divided into three groups according to ALT level.35 cases in group A,ALT≥2×upper limit of normal value(ULN)-5×ULN(100-250 IU/L);53 cases in group B,ALT＞5×ULN-≤10×ULN(251-500 IU/L);60 cases in group C,ALT＞10×U12/(＞500 IU/L)Flow cytometry is used to determine non-specific CTV.HBV specific CTL was tested on 74 cases of CHB(17 in group A,27 in group B and 30 in group C)with positive(HLA)-A2.Compare HBV specific CTL.non-specific CTL.HBV DNA levels and positive rate of HBeAg.Results HBV specific CTL:Group A(0.42±0.10)%is higher than group B(0.25±0.08)%,t=6.37,P＜0.01,group B is higher than group C(0.17±0.004)%,t=5.14,P＜0.01;Non-specific CTL:Group A(15.01±3.01)%is lower than group B(18.1±5.02)%,t=2.81,P＜0.01,group B is lower than group C(21.5±6.11)%,t=3.07,P＜0.01;HBV DNA level:Group A(4.97±0.86)log10 copies/ml]is lower than group B(5.92±0.92)1og10 copies/ml],t=4.87,P＜0.01.Group B is lower than group C(6.37±0.71)log10 copies/ml],t=2.92,P＜0.01;Positive HBeAg:Group A(15 cases,42.86%)is lower than group B(32 cases,60.38%),X2=2.59,P＞0.05.Group B is lower than group C(41 cases,68.33%),X2=0.78,P＞0.05.Group A is lower than group C,X2=5.929,P＜0.05.Conclusion The higher the lion-specific CTL of patients with CHB is,the higher the ALT level would be.whereas the lower the HBV specific CTL is.the stronger the HBV replication would be.