慢性丙型肝炎患者外周血T淋巴细胞亚群变化的临床分析

目的：分析慢性丙型肝炎（CHC）患者外周血T淋巴细胞亚群（CD3+、CD4+和CD8+细胞）以及调节性T淋巴细胞（CD4+CD25+Treg）表达与HCV RNA水平之间的关系。方法选取CHC 患者128例，根据HCV RNA水平高低将他们分为HCV RNA阴性组48例，低病毒组40例（HCV RNA<105 IU/mL），高病毒组40例（HCV RNA≥105 IU/mL），另外选取30名健康体检者作为对照组。检测4组样本的外周血T淋巴细胞亚群和调节性T淋巴细胞，分析各组间的差异。结果 CD4+CD25+Treg表达率在HCV RNA高病毒组、低病毒组、阴性组与健康对照组分别为（13.57±1.87）%、（9.38±1.74）%、（5.95±1.28）%和（5.89±1.15）%，差异存在统计学意义（F=35.28， P<0.01）。 CD4+CD25+Treg水平随HCV RNA的升高而升高，两者呈正相关（r=0.625， P<0.05）。 CD3+、CD4+及CD4+/CD8+在4组间的差异均有统计学意义（F=21.51、28.52和15.51，P均<0.01），其中外周血CD4+百分率及CD4+/CD8+在高病毒组均低于其他3组，在低病毒组均低于健康对照组和阴性组（P均<0.05）。结论 CHC患者外周血CD4+CD25+Treg升高与HCV RNA含量正相关，提示它可能参与了HCV感染慢性化的进程；外周血CD4+百分率及CD4+/CD8+随着HCV RNA水平的升高而明显降低，提示病毒复制水平越高，机体免疫抑制就越明显。

Clinical analysis of changes on peripheral blood T lymphocyte subsets in patients with chronic hepatitis C

Objective To analyze the relationship of the expression of peripheral blood T lymphocyte subsets (CD3+, CD4+and CD8+lymphocytes) and regulatory T cells (CD4+CD25+Treg) with the level of HCV RNA in the patients with chronic hepatitis C (CHC). Methods According to the level of HCV RNA, 128 CHC cases were divide into HCV RNA negative group (n=48), low virus group (n=40, HCV RNA<105 IU/mL) and high virus group (n=40, HCV RNA ≥105 IU/mL), and other 30 healthy persons were selected as control. The peripheral blood T lymphocyte subsets and regulatory T lymphocytes of 4 groups were detected. The differences were analyzed among the 4 groups. Results The expression of CD4+CD25+Treg in high virus group, low virus group, negative group and control group were (13.57±1.87)%, (9.38±1.74)%, (5.95±1.28)% and (5.89±1.15)%, respectively. There were statistical differences among the 4 groups (F=35.28, P<0.01). The level of CD4+CD25+Treg increased with the increasing of HCV RNA. The level of CD4+CD25+Treg showed positive correlation with HCV RNA (r=0.625, P<0.05). The differences of CD3+, CD4+and CD4+/CD8+among the 4 groups had statistical significances (F=21.51, 28.52 and 15.51, P all <0.01). Among them, CD4+ lymphocyte and CD4+/CD8+ in high virus groupwere lower than other 3 groups, and those in low virus group were lower than negative group and control group (P all<0.05). Conclusions The percentage of CD4+CD25+Treg in patients with CHC has positive correlation with the level of HCV RNA. It suggests that CD4+CD25+Treg may play a role in chronic progress of HCV infection. The percentage of CD4+lymphocyte and CD4+/CD8+decrease significantly with the increasing of HCV RNA level, which demonstrates that the higher the level of HCV RNA is, the more obvious the depression of immunity will be.