补肾方对慢性乙型肝炎T细胞亚群及其功能的影响

目的观察补肾方对慢性乙型肝炎患者免疫功能状态的调节作用。方法收集HBeAg阳性ALT异常者30例，给予补肾方治疗，用药6个月，于用药前、用药3个月、6个月时分别检测下列指标。采用罗氏荧光定量PCR法检测HBVDNA，外周血单个核细胞(peripheral blood mononuclear cell，PBMC)加入HBeAg、HBcAg与植物血凝素(Phytohemagglutinin，PHA)培养48h，检测培养上清液中IL-10、IFN-γ，血液中CD4^+、CD8^+、CD8^+CD28^+、CD8^+CD28^-和CD28^+T细胞的比例及加入HBeAg、HBcAg与PHA培养48h后培养细胞中CD8^+CD28^+的比例。结果补肾方治疗有效组在治疗3个月后，PBMC培养中IFN-γ较治疗前明显上升，IL-10明显下降(P<0．05，P<0．01)；CD8^+CD28^+T、CD28^+T、培养后CD8^+CD28^+T细胞较治疗前明显上升，CD8^+CD28^-T细胞明显下降(P<0．05或P<0．01)。结论补肾方能明显增强Th1型细胞因子的表达，降低Th2型细胞因子的表达，促进CD8^+(Cytotoxic T lymphocyte，CTL)的表达，这可能是使HBVDNA复制得到抑制的机制之一.

Effect of Bushen Recipe on T-cell Subsets and Their Function in Patients with Chronic Hepatitis B

OBJECTIVE: To observe the regulatory effect of Bushen recipe (BSR) on immune function in patients with chronic hepatitis B. METHODS: Thirty patients with HBeAg+ and abnormal alanine transaminase (ALT) level were treated with BSR for 6 months. The following parameters before treatment, 3 months and 6 months after treatment were tested: (1) HBV DNA by fluorescence quanitiative PCR; (2) Levels of interleukin-10 (IL-10) and interferon-gamma in supernatant of cultured peripheral blood mononuclear cell (PBMC) after had been cultured with HBeAg, HBcAg and phytohemagglutinin (PHA) for 48 hrs; (3) Blood levels of T-cells, including CD4+ , CD8+ , CD8+ CD28+ , CD8+ CD28- and CD28+ , and their ratio, as well as the percentage of CD8+ CD28+ in the cell culture after being co-cultured with PHA for 48 hrs. RESULTS: In patients effectively treated by BSR, after 3 months treatment, level of IFN-gamma in PBMC culture significantly increased, CD8+ CD28+ , CD28+ T-cells significantly enhanced and IL-10 and CD8 + CD28+ T-cells significantly decreased (P < 0.05, P < 0.01). CONCLUSION: BSR could significantly strengthen the expression of Th1 type cytokine, decrease the expression of Th2 type cytokine and promote the expression of CD8+ cytotoxic T-lymphocyte, which may be one of mechanisms in suppressing HBV DNA replication.