不同临床类型HBV感染者外周血T淋巴细胞亚群的变化

目的研究HBV感染者外周血T淋巴细胞亚群的变化及其临床意义.方法在33例慢性乙型肝炎轻度、50例中度、32例重度、64例肝硬化、51例慢性乙型肝炎肝衰竭和30例健康人,采用特异性荧光抗体标记法和流式细胞仪检测外周血T淋巴细胞亚群.结果慢性乙型肝炎重度、乙型肝炎肝硬化和慢性乙型肝炎肝衰竭患者与正常对照组比,CD3^＋、CD4^＋、CD8^＋细胞数和CD4^＋/CD8^＋比值显著下降（P〈0.05）,以慢性乙型肝炎肝衰竭下降最显著;HBeAg阴性患者外周血CD3^＋、CD4^＋和CD8^＋细胞数较HBeAg阳性患者显著减少（P〈0.05）;HBV DNA载量与患者外周血CD3^＋、CD4^＋、CD8^＋细胞数和CD4^＋/CD8^＋比值均无明显相关性.结论严重的HBV感染者存在不同程度的细胞免疫功能低下及免疫调节紊乱,细胞免疫功能下降程度与病毒复制水平无明显相关.

The change of peripheral blood T lymphocyte subsets among patients with different clinical types of hepatitis B

Objective To study the change of peripheral blood T lymphocyte subsets among patients with different clinical types of hepatitis B. Method In 33 patients with mild,50 with moderate and 32 with severe degree of chronic hepatitis B,64 with liver cirrhosis and 51 with chronic liver failure of hepatitis B,and in 30 healthy persons,the peripheral blood T lymphocyte subsets were determined by flow cytometry. Results The percentages of CD3^＋,CD4^＋,CD8^＋ cells and the ratio of CD4^＋/CD8^＋ decreased in patients with severe degree of chronic hepatitis B,liver cirrhosis and chronic liver failure of hepatitis B as compared to that in healthy persons or to that in patients with mild and moderate hepatitis B,and the change in chronic liver failure was the most significant;The percentages of CD3^＋,CD4^＋ and CD8^＋ cells in HBeAg negative group were significant lower than those in HBeAg positive group（P〈0.05）;There was no correlation of serum HBV DNA levels to the percentages of CD3^＋,CD4^＋,CD8^＋ cells in all the patients with hepatitis B. Conclusion Decreased percentages of T lymphocytes is observed in patients with severe hepatitis B.