慢性HBV感染者外周血T细胞亚群与病毒载量、HBeAg的相关性分析

目的：分析慢性HBV感染者外周血T细胞亚群与病毒载量、HBeAg的相关性。方法以40例慢性乙型肝炎（ CHB）、35例慢性重型乙型肝炎（ CSHB）、30例肝硬化（ LC）及32例正常对照者为研究对象，采用流式细胞仪和荧光定量PCR法分别检测各组外周血T细胞亚群、HBV DNA载量。结果 CHB组仅CD^4＋亚群明显降低，与对照组比较，差异有统计学意义（ P ＜0．05）；CSHB及LC组CD^3＋、CD^4＋亚群、CD^4＋/CD^8＋比值呈逐渐降低趋势，CD^8＋亚群呈逐渐增高趋势，与对照组比较差异有统计学意义（ P ＜0．05）。 HBV DNA载量与CD^4＋亚群、CD^4＋/CD^8＋比值呈负相关（ r ＝-0．638，-0．778， P ＜0．05），与CD^8＋亚群呈正相关（ r ＝0．647， P ＜0．05），与CD^3＋无关。与HBeAg阳性患者比较，HBeAg阴性患者外周血CD^＋3＋、CD^4＋和CD^8＋亚群显著降低（ P ＜0．05）。结论慢性HBV感染者随着疾病加重细胞免疫功能进行性降低，与病毒复制水平密切相关，这是导致疾病慢性化的原因之一。外周血T细胞亚群变化趋势可为判断疾病转归及预后提供可靠指标。

The correlation between T lymphocyte subsets in peripheral blood and HBV DNA levels as well as HBeAg in patients with chronic hepatitis B virus infection

Objective To investigate the relationship between T-lymphocyte subsets and HBV DNA levels ,HBeAg in patients with chronic hepatitis B virus （ HBV） infection.Methods The 40 cases of chronic hepatitis （ CHB）,35 cases of chronic severe hepatitis B （ CSHB） ,30 cases of liver cirrhosis （ LC） and 32 healthy subjects were enrolled in the study .The T lymphocyte subsets and HBV DNA load in peripheral blood were detected by flow cytometry and fluorescence quantitative PCR for all the patients and healthy subjects .Results The CD^4＋subset was significantly decreased in CHB group ,as compared with that in control group （ P 〈0.05）;the CD^3＋,CD^4＋subsets,the ratio of CD^4＋/CD^8＋in CSHB group and LC group were gradually decreased,however,CD^8＋subset was gradually increased ,as compared with those in control group （ P 〈0.05）.HBV DNA load was negatively correlated to CD 4＋subset,ratio of CD^4＋/CD^8＋（ r =-0.638,-0.778, P 〈0.05）,however,which was positively correlated to CD^8＋subset （ r =0.647, P 〈0.05）,moreover,which was not related with CD 3＋subset.As compared with those of patients with positive HBeAg ,the CD^＋3 subset ,CD^4＋subset and CD 8＋subset in peripheral blood of patients with negative HBeAg were significantly decreased （ P 〈0.05 ）.Conclusion The cellular immune function in patients with chronic HBV infection is progressively decreased with the aggravation of disease condition , which is closely correlated to the levels of virus replication ,and it is one of the reasons that results in chronicity of disease .The changing trend of T lymphocyte subsets in peripheral blood can be regarded as a reliable index for evaluating disease ’s prognosis.