慢性乙型肝炎患者外周血淋巴细胞亚群与病程相关性的研究

目的对慢性乙型肝炎轻中度、重度和肝硬化患者外周血淋巴细胞亚群的百分比和绝对细胞数进行观察,探讨慢性乙型肝炎患者外周血淋巴细胞亚群的变化与病程的关系.方法采集88例慢性乙型肝炎患者柠檬酸钠新鲜抗凝血,经流式细胞仪进行免疫分型检测.结果慢性乙型肝炎重度患者的CD3+CD4+细胞百分比显著低于轻中度患者(P＜0.05),肝硬化患者的CD3+和CD3+CD8+细胞百分比显著低于轻中度患者(P＜0.01).肝硬化患者CD3CD19+细胞百分比显著高于重度和轻中度患者(P＜0.01).CD4/CD8比例在慢性乙型肝炎轻中度、重度和肝硬化患者间无显著差异.肝硬化和重度患者淋巴细胞、CD3+、CD3+CD4+、CD3+CD8+细胞的绝对细胞数均显著低于轻中度患者(P＜0.01),且肝硬化患者CD3-CD16+56+细胞的绝对细胞数显著低于轻中度患者(P＜0.05).肝硬化患者与轻中度患者的DNA载量分布差异有显著性(P＜0.01),其高水平病毒载量的患者比例高于轻中度患者.结论慢性乙型肝炎轻中度发展为重度和肝硬化的过程中,外周血淋巴细胞亚群绝对细胞数随病情的进展显著减少,主要表现为CD3+CD4+和CD3+CD8+的T淋巴细胞亚群的百分比进行性降低.

Association of peripheral blood lymphocyte subsets with disease progression in patients with chronic hepatitis B infection

Objective To determine the percentage and absolute number of peripheral blood lymphocyte subsets and to appraise their correlation with the disease progression in patients with chronic hepatitis B infection.Methods Fresh sodium citrate anti coagulated peripheral blood samples were collected from 88 chronic hepatitis B patients. The phenotypes of peripheral blood lymphocyte subsets were analysed by flow cytometry.Results The HBV infected cirrhotic patients had a significantly lower percentage of CD3 + and CD3 + CD8 + lymphocytes than patients with mild or moderate chronic B hepatitis infection ( P < 0.01 ). For the percentage of CD3 + CD4 + lymphocytes, the patients with severe chronic liver disease were significantly lower than those with mild or moderate chronic liver disease ( P <0.05.) Furthermore, compared to patients with mild or moderate chronic liver disease, the cirrhotic patients had significantly increased percentage of CD3 - CD19 + T lymphocytes ( P <0.01). With respect to the ratio of CD4/CD8, there were no significant differences among the patients with chronic B hepatitis. The absolute number of lymphocytes CD3 +, CD3 + CD4 + and CD3 + CD8 + lymphocytes in patients with severe chronic B hepatitis disease and liver cirrhosis were both dramatically lower than the those with mild or moderate chronic liver disease ( P <0.01). Patients with liver cirrhosis had a dramatically lower absolute number of CD3 - CD16 +56 + lymphocytes than those with mild or moderate chronic liver disease ( P <0.05). There was a significant difference in the viral loads in patients with mild or moderate liver disease and liver cirrhosis ( P <0.01), in the latter the viral loads being higher.Conclusion Among the patients with mild, moderate and severe B hepatitis and liver cirrhosis, the absolute number of peripheral blood T lymphocyte subsets in patients with chronic HBV infection decrease significantly and are correlated with the disease progression.