慢性丙型肝炎患者治疗前后外周血T细胞CD28、CD152水平变化分析

目的 观察慢性丙型肝炎患者治疗前后外周血T细胞CD28、CD152水平变化,为慢性丙肝临床治疗提供依据.方法 选择40例慢性丙型肝炎患者作为观察组,40例健康人作为对照组,利用流式细胞仪测定用荧光抗体CD4-PECY5、CD8-PE标记过的患者CD4＋淋巴细胞和CD8＋淋巴细胞表面CD28、CD152表达水平,分析其治疗前后变化水平.结果 观察组慢性丙型肝炎患者治疗前CD4＋ CD28、CD8＋ CD28明显低于对照组（P＜0.05）;观察组患者经过治疗后CD4＋ CD28、CD8＋CD28明显升高（P＜0.05）;治疗后观察组患者CD4＋ CD28、CD8＋ CD28与对照组相比较无明显差异（P＞0.05）;观察组慢性丙型肝炎患者治疗前CD4＋ CD152明显高于对照组（P＜0.05）;观察组慢性丙型肝炎患者治疗前CD8＋ CD152与对照组无明显差异（P＞0.05）;观察组患者经过治疗后CD4＋ CD152明显降低（P＜0.05）,CD8＋ CD152＋无明显变化（P＞0.05）;治疗后观察组CD4＋ CD152＋、CD8＋ CD152与对照相比较无明显差异（P＞0.05）;治疗前HCV-RNA阳性率为82.5％ （33/40）,治疗后为17.5％ （7/40）,治疗后HCV-RNA阳性率明显降低（P＜0.05）.结论 外周血T细胞CD28、CD152水平变化能反映慢性丙型肝炎患者HCV RNA复制情况及免疫系统状态.

Changes of CD28, CD152 on surface of peripheral blood T cells after treatment in patients with chronic hepatitis C

Objective To investigate the changes of CD28 ,CD152 on surface of peripheral blood T ceils after treatment in patients with chronic hepatitis C for providing a basis in the clinical treatment of chronic hepatitis C. Methods Forty cases of chronic hepatitis C （observation group） and 40 healthy controls were enrolled in this study. The levels of CD28 and CD152 on CD4 ＋ lymphocyte and CD8 ＋ lymphocyte surface were detected by flow cytometry. Results The levels of CD4 ＋ CD28 and CD8 ＋ CD28 in patients with chro- nic hepatitis C were significantly lower than those in healthy controls before treatment （ P 〈 0.05 ）. The levels of CD4 ＋ CD28, CD8 ＋ CD28 increased significantly after treatment in observation group （P 〈 0.05 ）. There was no significant difference in CD4 ＋ CD28, CD8 ＋ CD28 between observation group and control group after treatment（P 〉 0.05 ）. The level of CD4 ＋ CD152 in observation group was sig- nificantly higher than that in control group before treatment （P 〈 0.05）. There was no significant difference in CD8 ＋ CD152 before treatment between observation group and control group （ P 〉 0.05 ）. The level of CD4 ＋ CD152 decreased significantly in observation group after treatment （P 〈0.05 ）,while CD8 ＋ CD152 ＋ had no significant change （P 〉 0.05 ）. There was no significant difference in CD4 ＋ CD152 ＋ , CD8 ＋ CD152 between observation group and control group （ P 〉 0. 05 ）. The positive rate of HCV-RNA was 82.5% （33/40） before treatment, and significantly decreased after treatment 17.5 % （7/40）, P 〈 0.05 ]. Conclusion The change of T cells in the peripheral blood CD28, CD152 levels can determine the HCV RNA replication and immune system of patients with chronic hepatitis C.