慢性乙型肝炎PBMC凋亡及淋巴细胞亚群的检测

目的了解慢性/慢性重型乙型肝炎外周血淋巴细胞激活诱导细胞死亡(AICD)现象的存在情况、各免疫细胞的状况、AICD与淋巴细胞状况的关系,以探讨乙型肝炎慢性化和重型化的机制.方法利用慢性、慢性重型乙型肝炎病人和健康献血员外周血单个核细胞(PBMC)在PHA-P刺激下培养72h,通过流式细胞仪检测PBMC的凋亡情况;采用流式细胞仪结合全自动血液分析仪对慢性、慢性重型乙型肝炎病人及正常对照组外周血各淋巴细胞亚群进行检测.结果慢性乙型肝炎组PBMC凋亡率高于慢性重型乙型肝炎组(P＜0.01),高于正常对照组(P＜0.01).慢性乙型肝炎组总淋巴细胞百分率高于慢性重型乙型肝炎组(P＜0.01),慢性重型乙型肝炎组淋巴细胞数低于正常对照组(P＜0.01);CD3+、CD3+CD4+细胞数低于正常对照组(P＜0.01),低于慢性乙型肝炎组(P＜0.05);CD3+CD8+细胞数低于正常对照组(P＜0.05),低于慢性乙型肝炎组(P＜0.05).单核细胞百分率高于正常对照组(P＜0.01),高于慢性乙型肝炎组(P＜0.05).结论慢性乙型肝炎患者外周血淋巴细胞活化与凋亡共存,慢性重型乙型肝炎患者外周血淋巴细胞消耗严重,AICD参与乙型肝炎慢性化、重型化的发生机理.     

不同类型HBV感染者外周血Treg/Th17细胞的变化及意义

目的:探讨不同类型HBV感染者外周血中CD4+ Foxp3+ Treg/Th17细胞的变化及意义.方法:选取15例急性乙型肝炎(Acute Hepatitis B,AHB)患者、40例慢性乙型肝炎(Chronic hepatitis B,CHB)患者、40例无症状携带者(Asymptomatic HBV carriers,AsC)及30例健康对照者,分别采用流式细胞术、RT-PCR和ELISA检测外周血CD4+ Foxp3+ Treg/Th17细胞百分率、核转录因子foxhead winged-helix box protein 3 (Foxp3)/retinoid-related orphan receptor gamma-t (RORγt) mRNA的表达以及血浆转化生长因子-β1(Transforming growth factor-31,TGF-β1)/IL-17的水平.结果:AHB组患者CD4+ Foxp3+ Treg/CD4+T细胞百分率、Foxp3 mRNA及TGF-β1水平与正常对照组相比无明显差异(P＞0.05);而CD4+ IL-17 +/CD4+T细胞百分率、RORγtmRNA及IL-17水平与正常对照组相比明显升高,差异有统计学意义(P＜0.05).CHB组患者CD4+ Foxp3+ Treg/CD4+T细胞百分率、Foxp3 mRNA、TGF-31水平及CD4+ IL-17 +/CD4+T细胞百分率、RORγt mRNA、IL-17水平与正常对照组相比均明显升高,差异有统计学意义(P＜0.05);与正常对照组相比,AsC组患者CD4+ Foxp3+ Treg/CD4+T细胞百分率、Foxp3 mR-NA、TGF-β1水平及CD4+ IL-17 +/CD4+T细胞百分率、RORγt mRNA、IL-17水平无明显差异(P＞0.05).结论:在不同类型HBV感染者外周血中Treg/Th17细胞失衡,Treg/Th17细胞可能与HBV感染的状态有关.     

浆细胞性乳腺炎患者外周血CD4+CD25+CD127-调节性T细胞变化

目的:观察浆细胞性乳腺炎(Plasma cell mastitis,PCM)患者外周血CD4+ CD25+ CD127-调节性T细胞(CD4+CD25+ CD127-Treg)数量和功能变化,以探讨PCM免疫病理机制.方法:将58例浆细胞乳腺炎患者分成三组:其中急性组13例(22％)、亚急性组25例(43％)和慢性组20例(34％).并设正常对照组20例及乳腺癌对照组16例.以流式细胞术检测各型PCM患者外周血中CD4 +CD25+ CD127 Treg细胞百分率;实时荧光定量RT-PCR检测转录因子Foxp3表达及ELISA检测TGF-β水平.结果:三组PCM组与正常组相比,外周血CD4+ CD25+ CD127 Treg数量,外周血PBMC中Foxp3表达及血浆TGF-β水平均下降(P＜0.05),其中急性PCM组下降最为明显(P＜0.01),乳腺癌组三项指标均升高(P＜0.05).结论:浆细胞性乳腺炎患者的CD4+ CD25+ CD127-Treg数量及功能有所下降.     

再生障碍性贫血患者外周血CD4~＋CD25~＋调节性T细胞及Foxp3的变化及临床意义

目的:探讨再生障碍性贫血(AA)患者外周血中CD4+CD25+调节性T细胞(Tress)及Foxp3的表达及临床意义.方法:25例AA病人,其中含非重型再障(nSAA)18例、重型再障(SAA)7例,采用四色流式细胞检测技术分析从患者外周血单个核细胞(PBMC)中CD4+T细胞、CD4+CD25+/CD4+、CD4+CD25high/CD4+T细胞百分比及绝对计数,并进一步分析AA患者PBMC的CD4++CD25+、CD4+CD25low及CD4+CD25highT细胞中Foxp3+T细胞的百分比,同时利用RT-PCR方法检测PBMC中Foxp3mRNA表达水平,并与29例正常对照组的上述指标进行比较.结果:与正常对照组相比,SAA患者及nSAA患者PBMC中CDM+T细胞、CD4+CD25+/CD4+、CD4+CD25high/CD4+百分比及绝对计数减低(P<0.05),并且SAA组明显低于nSAA组(P<0.001);从患者CD+CD25+、CD4+CD25low及CD4+CD25highT细胞中Foxp3的表达较正常对照组减低(P<0.05);AA患者PBMC中Foxp3 mRNA表达水平与正常对照组没有明显差别(P>0.05).结论:CD4+CD25+调节性T细胞减低可能与从的发病有关,SAA的Treg表达低于nSAA,为其作为从病情变化的判断指标提供进一步的依据.     

结核病患者外周血T细胞亚群、mIL-2R与sIL-2R的测定

采用生物素 链霉亲和素 (BSA)系统检测 85例结核病患者T细胞亚群及经PHA诱导前后其mIL 2R表达水平 ,用ELISA法测定其血清sIL 2R水平 ,同时选取健康献血员 2 5名为正常对照 ,操作按说明书进行。资料分析采用t检验。从表 1可见 :结核病患者外周血CD3+ 、CD4 + 百分率、CD4 + CD8+ 比值均低于正常对照 (P <0 .0 1) ;CD8+ 百分率、　　表 1　结核病患者与正常对照组中外周血T细胞亚群、PBMC经PHA诱导前后mIL 2R表达水平和血清sIL 2R检测结果[n , x±s ;百分率 (% ) ]组别n CD3 + ( % )CD4+ ( % )CD8+ ( % )CD4+ CD8+sI…     

外周血CD4+CXCR5+滤泡辅助性T细胞与慢性乙型肝炎患者高球蛋白血症相关

目的 检测外周血CD4+ CXCR5+滤泡辅助性T细胞(Tfh细胞)的频率及其表面标志,分析与慢性乙型肝炎(乙肝)患者高球蛋白血症的关系.方法 收集健康人、乙肝患者及乙肝高球蛋白血症患者的外周血,分离血浆及外周血单个核细胞(PBMC),ELISA检测血浆中IL-21、CXCL13和IFN-γ水平,流式细胞术检测PBMC中CD4+ CXCR5+ Tfh细胞的频率及其表面PD-1、ICOS及CD40L的表达情况.结果 乙肝高球蛋白血症患者外周血CD4+ CXCR5+ Tfh细胞占CD4+T细胞的百分比(22.6±4.7)％明显高于普通慢性乙肝患者(11.9±3.9)％及健康志愿者(6.8±3.9)％,CD4+ CXCR5+ Tfh细胞上PD-1和CD40L的表达水平升高,血清IL-21及CXCL13水平升高,而IFN-γ水平降低,差异具有统计学意义(P＜0.05).结论 外周血CD4+ CX-CR5+ Tfh细胞与乙肝高球蛋白血症的发病相关.     

慢性髓系白血病患者外周血T淋巴细胞亚群和NK细胞检测的临床意义

目的 研究不同分期慢性髓系白血病患者外周血T淋巴细胞亚群、NK细胞的变化特点,以及应用伊马替尼治疗后获得完全细胞遗传学反应(complete cytogenetic reponse,CCyR)患者淋巴细胞亚群表达情况.方法 选取我院诊治40例慢性髓系白血病患者,其中急变期9例,慢性期31例.采用流式细胞术检测外周血T淋巴细胞亚群、NK细胞水平,并与正常对照组进行比较.结果 初治慢性期、急变期CML患者外周血CD3+、CD4+、CD8+T细胞百分率及CD4+/CD8+比值均低于正常对照组,且急变期CD3+、CD4+T细胞百分率及CD4 +/CD8+比值下降尤为突出(P＜0.01);初治慢性期患者NK细胞百分率与正常对照组相比无差异,而急变期患者低于正常对照组(P＜0.05).与正常组对比,伊马替尼治疗首次获得完全细胞遗传学反应患者仅CD4+T细胞百分率降低,差异具有统计学意义(P＜0.05);但获得完全细胞遗传学反应后应用伊马替尼治疗大于12月患者,CD3+、CD4+T细胞百分率及CD4 +/CD8+比值较正常对照组均有所下降(P＜0.05).与治疗前相比,治疗首次获得完全细胞遗传学反应患者CD3+、CD4+T细胞百分率升高(P＜0.05),而缓解后应用伊马替尼治疗大于12月患者T淋巴细胞亚群无改变(P＞0.05);各组的NK细胞百分比无差异(P＞0.05).初诊CML患者、急变期CD4+/CD8+的比值与BCR-ABLl/ABL1的比值呈负相关.结论 CML患者存在细胞免疫调节功能异常,且机体免疫功能与疾病分期密切相关.伊马替尼治疗初次获得完全细胞遗传学反应患者细胞免疫功能得到改善,但长期应用抑制患者细胞免疫功能.     

慢性活动性肝炎患者外周血CD56+细胞及其CD69表达的检测

目的:检测慢性活动性乙型肝炎(CAHB)患者外周血CD56 细胞及CD56 CD69 活化细胞,探讨他们在乙型肝炎发病中的作用。方法:以31例正常人作为对照,采用免疫荧光三色标记流式细胞术,检测30例CAHB患者外周血CD56 细胞及其CD69抗原的表达;同时用荧光定量PCR检测CAHB患者的血清病毒DNA载量。结果:CAHB患者外周血CD56 细胞的百分率(21.24%±6.28%)与正常人对照(18.24%±6.96%)相比较差异显著(P<0.05);CD56 细胞上CD69的表达(4.02%±1.57%)与正常人对照组(1.26%±0.62%)相比较差异也显著(P<0.01)。CD56 细胞数与CD56 CD69 细胞数之间呈正相关;CD56 细胞数与血清病毒DNA载量之间呈负相关。结论:CAHB患者外周血存在CD56 细胞的异常激活,提示其在抗病毒感染中起重要作用。CD56 细胞数的改变可能与患者病情的严重程度有关。     

原发性胆汁性肝硬化患者共刺激分子B7-H4的检测及临床意义

目的 探讨原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)患者共刺激因子B7-1t4的表达及其与疾病发病机制的关系.方法 分别采用荧光实时定量PCR法(real-time PCR)、酶联免疫吸附试验(ELISA)及流式细胞术(FCM)检测65名PBC患者外周血单个核细胞(PBMC)B7-H4mRNA表达水平、血清IL-2水平以及CD4+、CD8+ T细胞亚群和T细胞表面B7-H4表达百分率,同时监测抗线粒体抗体(anti-mitochondrial antibody,AMA)及临床各项生化指标的关系.结果 (1)PBC患者PBMC B7-144 mRNA水平及T细胞表面B7-H4表达百分率显著低于非PBC肝硬化组及健康对照组(P<0.01).(2)活化72 h后各实验组及对照组IL-2含量及CD4+、CD8+、CD4+ CD8+T淋巴细胞表达水平均低于活化前,以非PBC肝硬化组与健康对照组降低显著(P<0.05);PBC组IL-2含量及CD4+、CD4+ CD8+ T淋巴细胞表达水平高于非PBC肝硬化组与健康对照组(P<0.01).(3)AMA-M2阳性患者血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)及γ-谷氨酰转肽酶(GGT)水平升高,其中ALP及GGT升高显著(P<0.05);AMA-M2阳性患者与阴性患者T细胞表面B7-H4表达百分率差异无统计学意义(P>0.05).结论 共刺激因子B7-H4对PBC患者体内T细胞活化增殖及细胞因子分泌的抑制作用减弱,为研究PBC的发生发展和阐明PBC的发病机制提供了试验资料.     

CD4~+CD25~+调节性T细胞在自身免疫性甲状腺疾病中数量和功能变化

目的:探讨自身免疫性甲状腺疾病患者外周血中CD4+CD25+调节性T细胞(Tregs)的数量和功能变化。方法:采用化学发光法测定20例初发Graves’病人、20例初发桥本甲状腺炎(HT)患者及20例健康体检者血清中促甲状腺素(TSH)、总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、甲状腺球蛋白抗体(TgAb)和甲状腺过氧化酶抗体(TPOAb)的水平;用流式细胞仪分析外周血单个核细胞(PBMC)中CD4+T细胞及CD4+CD25+Tregs的数量;采用磁珠分选技术分选5例HT病人和5例健康体检者PBMC中CD4+CD25+Tregs和CD4+CD25-T细胞,采用MTT法检测CD4+CD25+Tregs对自身CD4+CD25-T细胞增殖的抑制作用;提取各组PBMC的总RNA,经Real time-PCR检测TGFβ-1、Foxp3 mRNA的表达水平。结果:流式细胞检测结果显示,初发Graves’病人、初发HT患者外周血PBMC中CD4+T细胞数量与正常人比较无差异(P<0.05);初发HT患者外周血PBMC中CD4+CD25+Tregs占CD4+T细胞的比率为(1.55%±0.49%),明显低于正常对照组(2.86%±1.04%)(P<0.05);初发Graves’病人外周血PBMC中CD4+CD25+Tregs占CD4+T细胞的比率为(3.25%±0.97%),与正常对照组(2.86%±1.04%)相比无显著性差异(P<0.05)。MTT结果显示,初发HT患者CD4+CD25+Tregs对自身CD4+CD25-T细胞增殖的抑制百分率为15.7%±5.36%,与正常组(41.7%±9.87%)相比显著降低(P<0.05)。Real time-PCR结果显示,初发Graves’病人、初发HT患者PBMC的TGFβ-1 mRNA表达水平分别为(0.37±0.10)和(0.43±0.09),均明显低于正常对照组(1.02±0.04)(P<0.05);初发Graves’病人、初发HT患者PBMC的Foxp3 mRNA表达水平分别为0.62±0.09和0.42±0.29,均明显低于正常对照组(0.99±0.17)(P<0.05)。结论:本研究结果提示,HT患者外周血中CD4+CD25+Tregs的数量和功能明显降低。Graves’病和HT患者外周血PBMC中TGFβ-1、Foxp3 mRNA表达水平明显降低。     

肝移植后他克莫司血药浓度对外周血单个核细胞内HBV DNA的影响

背景：肝移植后他克莫司等免疫抑制剂的长期应用导致机体细胞免疫功能降低,并有可能影响机体对乙肝病毒的清除。 目的：分析乙肝相关肝移植患者后不同浓度他克莫司对外周血单个核细胞中的HBV DNA含量的影响。 方法：纳入乙肝相关终末期肝病肝移植受者23例,根据移植后12周清晨空腹他克莫司血药浓度,分为高浓度组(≥ 10 μg/L) 9例和低浓度组(< 10 μg/L)14例,同时用荧光标记单克隆抗体结合流式细胞技术检测外周血T细胞亚群的百分比,用实时荧光定量PCR检测外周血单个核细胞内的HBV DNA。 结果与结论：用多元线性回归分析外周血单个核细胞内的HBV DNA含量与CD8⁺CD152⁺呈正相关,与CD8⁺CD28⁺呈负相关。高血药浓度他克莫司的患者外周血单个核细胞内的HBV DNA高于低浓度组,其改变与反映细胞免疫功能的指标CD8⁺CD152⁺和CD8⁺CD28⁺的变化有关。     

The expression of CD2 in chronic HBV infection

It was previously reported that several kinds of intercellular adhesion molecules are closely related to chronic HBV infection. The complex of CD2 and CD58 plays an important role in enhancing the adhesion of T lymphocytes to target cells, and promoting hyperplasia and activation of T lymphocytes. In this study, we detected the level of CD2 expressed on the surface of PBMC, the expression level of CD2 mRNA in PBMC and the percentage of CD2 positive cells in PBMC of patients with chronic HBV infection and compared them with the expression level of normal controls. We also determined the level of serum HBV DNA from patients with chronic HBV infection and from normal controls. The clinical characteristics of hepatic function were tested as well. The results showed that the expression of CD2 significantly increased with the severity of chronic HBV infection, which suggested that CD2 might contribute to the hepatocyte damage in chronic HBV infection. Cellular ＆ Molecular Immunology.     

Increased hepatitis C virus (HCV)-specific CD4+CD25+ regulatory T lymphocytes and reduced HCV-specific CD4+ T cell response in HCV-infected patients with normal versus abnormal alanine aminotransferase levels

CD4+CD25+ T regulatory cells may play a role in the different clinical presentations of chronic hepatitis C virus (HCV) infection by suppressing CD4+ T cell responses. Peripheral CD4+CD25+ T cells from chronic HCV carriers with normal and abnormal alanine aminotransferase (ALT) were analysed for specificity and effect on HCV-specific CD4+ T cell reactivity by flow cytometry for intracellular cytokine production and proliferation assay. HCV-specific CD4+CD25(+high) T cells consistently produced transforming growth factor (TGF)-beta but only limited amounts of interleukin (IL)-10 and no IL-2 and interferon (IFN)-gamma. The HCV-specific TGF-beta response by CD4+CD25(+high) T cells was significantly greater in patients with normal ALT compared to patients with elevated ALT. In addition, a significant inverse correlation was found between the HCV-specific TGF-beta response by CD4+CD25(+high) T cells and liver inflammation. In peripheral blood mononuclear cells (PBMC), both HCV antigen-induced IFN-gamma production and proliferation of CD4+ T cells were greater in patients with elevated ALT compared with patients with normal ALT. Depletion of CD4+CD25+ cells from PBMC resulted in an increase of both IFN-gamma production and proliferation of HCV-specific CD4+ T cells that was significantly greater in patients with normal ALT levels compared with patients with elevated ALT. In addition, CD4+CD25+ T cells from patients with normal ALT levels proved to be significantly more potent to suppress CD4+ T cell reactivity with respect to those from patients with elevated ALT. In conclusion, these data support the hypothesis that CD4+CD25+ cells may play a role in controlling chronic inflammatory response and hepatic damage in chronic HCV carriers.     

Influence of hepatitis B virus virema upon serum aminotransferase activity in dialysis population

BACKGROUND: The control of the spread of hepatitis B virus (HBV) infection within dialysis units has been one of the major advances in the management of patients with end-stage renal disease (ESRD). However, clinical and biochemical expression of HBV in dialysis patients have not been adequately addressed. Elevated values of serum aminotransferase activity are a sensitive measure of hepatocellular injury, but the role of HBV infection in the development of liver disease among dialysis patients has not been adequately analysed. Also, the clinical impact related to the virological characteristics of HBV in dialysis has not been evaluated. METHODS: Demographic, biochemical and virological data from 727 patients undergoing chronic dialysis in seven dialysis units in northern Italy were collected in order to assess the biochemical consequences related to the presence of HBV infection in this population. We have measured by RT-PCR technology the titers of HBV viremia in HBsAg positive patients receiving dialysis. RESULTS: Univariate analysis showed that AST and ALT values were significantly higher in HBsAg positive/HBV DNA positive than HBsAg negative patients on dialysis; AST, 22.86+/-31.34 vs. 14.19+/-9.7 IU/L (P=0.00001); and ALT, 25.07+/-41.59 vs. 13.9+/-41.59 IU/L (P=0.00001). In the subgroup of HBsAg positive patients, the frequency of detectable HBeAg in serum was 14.9% (7/47). The median value of HBV DNA in patients with detectable HBV DNA in serum was 2.160 x 10(3) copies/mL (range, 2.5 x 10(2)-4 x 10(6) copies/mL). HBsAg positive/HCV positive patients had higher aminotransferase activity than other subgroups (P=0.0001). Multivariate analysis showed a significant and independent association between detectable HBsAg/HBV DNA in serum and AST (P=0.00001) and ALT (P=0.0001) activity AST and ALT levels were lower in dialysis than healthy individuals--this finding persisted in age- and gender-matched comparisons. CONCLUSIONS: The HBV viral load in HBsAg positive patients receiving maintenance dialysis is not high. HBsAg positivity with detectable HBV DNA in serum is a strong and independent predictor of raised aminotransferase activity among dialysis patients. HBsAg positive patients had greater aminotransferase activity than HBsAg negative individuals even if both the groups had mean aminotransferase levels within the normal range considered for healthy population. Clinical trials aimed at identifying the best cut-off value to enhance the diagnostic yield of AST/ALT for detecting HBV in dialysis population are under way.     

活化Th细胞及HBeAg与慢性乙肝肝损伤及纤维化关系的探讨

目的探讨活化Th细胞（CD4^＋HLA-DR^＋）及HBeAg与慢性乙型肝炎肝脏损伤及纤维化的关系。方法检测58例慢性乙型肝炎患者和18例既往感染患者（HBsAg阴性而HBcAb阳性者）CD4^＋抗原和HLA-DR抗原双阳性淋巴细胞,血小板（PLT）数和血清丙氨酸氨基转移酶（ALT）和天门冬氨酸氨基转移酶（AST）活度,计算AST／PLT比值。结果既往感染患者、HBeAg阴性及阳性慢性乙肝患者活化CD4^＋细胞数量明显低于对照者（P〈0．05）,且呈显著递减（P〈0．05）,HBeAg阴性及阳性者AST,ALT以及AST／PLT值明显高于对照者（p〈0．02）和既往感染者（P〈0．02）,且HBeAg阳性患者明显高于阴性患者（P〈0．05）,此二组活化CD4^＋细胞与ALT,AST和AST／PLT呈明显负相关（P〈0．05）。结论活化Th细胞降低可以作为慢性乙肝患者预测肝脏损伤进展的有用指标,HBeAg可以辅助评价肝损伤和纤维化的发展程度。     

乙型肝炎病毒基因型不同的患者肝功能相关指标及免疫功能变化分析

目的 探讨基因型不同的乙肝患者肝功能、病毒载量和免疫功能的差异及临床意义.方法 145例乙肝患者划分两个年龄段:小于35岁和大于35岁,全部应用实时荧光PCR法进行乙型肝炎病毒(HBV)基因分型检测;同时采用实时荧光PCR法检测血清HBV-DNA载量;用全自动生化分析仪和流式细胞仪检测各组肝功能相关指标及淋巴细胞亚群含量.结果 145例HBV患者仅为两种基因型,B基因型62例(42.76％),C基因型83例(57.24％).B型患者谷丙转氨酶(ALT)、谷草转氨酶(AST)和HBV-DNA均稍高于C型,分别是[(263.6±36.13) U/L比(243.1±37.69) U/L]、[(128.1±15.84) U/L比(123.6±19.1)U/L]和[(6.131±0.2133)比(5.875±0.1725)],进行统计学分析后差异均无统计学意义(P＞0.05),但划分年龄段后,大于35岁的患者,B型ALT、AST和HBV-DNA均显著高于C型(P＜0.05),分别是[(227.6±34.52) U/L比(144.8±19.92) U/L]、[(124.5±19.4) U/L比(79.79±12)U/L]和[(6.166±0.2582)比(5.228±0.2644)].淋巴细胞亚群分析可见,所有年龄段或大于35岁患者均是B型的CD4+T细胞比例显著低于C型[(32.97±0.95)％比(35.81±0.85)％](P＜0.05),CD8+T细胞显著高于C型[(30.19 ±0.97)％比(27.44±0.92)％](P＜0.05),而CD3+T细胞、B细胞、NK细胞在B型和C型患者中则差异无统计学意义(P＞0.05).结论 145例HBV患者B、C型的分布未见显著差异;肝功能、病毒载量及T细胞亚群在年龄较大的B、C两组患者中存在显著差异.     

苦参碱对慢性乙型肝炎患者T细胞亚群的影响

目的探讨苦参碱治射液对慢性乙型肝炎患者外周血T细胞免疫的影响。方法采用SAP法检测30例慢性乙型肝炎患者外周血T细胞亚群。结果有2例感染者达到完全应答,12例部分应答,16例无应答;苦参碱治疗后外周血CD3 T细胞较治疗前明显增高,应答组CD4 T细胞显著高于无应答组。结论用苦参碱治疗慢性乙型肝炎患者可以影响患者T细胞免疫,使患者CD4 T细胞水平明显增高。     

Occult hepatitis B in HIV-infected patients

Prevalence of hepatitis B virus (HBV) markers, including occult HBV, has not been described in diverse cohorts among HIV-infected patients. The objective of this study was to assess prevalence and significance of active and occult HBV infection in an HIV-positive US cohort. A random sample was taken from 2 prospective multicenter treatment intervention cohorts. The sample population (n = 240) was HIV-1 infected and highly active antiretroviral therapy-naive. Prevalence of HBV serologic markers and quantitative HBV DNA were determined. Serum alanine aminotransferase (ALT) levels were measured to evaluate correlates of hepatocyte injury. A total of 64.6% of subjects demonstrated reactivity for any marker of current or past HBV infection or prior vaccination. Chronic HBV infection characterized by hepatitis B surface antigen (HBsAg) reactivity was present in 7.1% while 15.8% exhibited HB anticore IgG only. Approximately 10% of the latter group was HBV DNA positive by a polymerase chain reaction-based assay. Only patients with a serologic pattern of HBsAg or HB anticore alone reactivity had HBV DNA. Occult HBV was observed in approximately 10% of HIV-infected patients with HB anticore IgG antibody in a geographically representative national cohort. Though viral titers and serum ALT levels were low, screening of this subset of HIV-infected patients may have implications in terms of antiretroviral therapy and risk of immune reconstitution-associated flares.     

小儿慢性乙型肝炎外周血T细胞亚群和临床病理关系的研究

目的　探讨小儿慢性乙型肝炎细胞免疫功能与临床、病理的关系 ,了解其间的相关性。方法　研究对象为确诊的 94例 12岁以内慢性乙型肝炎住院患儿。常规检测血T细胞亚群等、血丙氨酸转氨酶 (ALT)水平、病毒学指标 ,并进行腹部B超、肝脏病理学检查。结果　有活动性肝脏病理炎症者CD4 CD8 升高 (P <0 0 5 ) ;女性比男性CD4 降低差异有非常显著意义 (P <0 0 1)、CD8 升高差异有显著意义 (P <0 0 5 )、CD4 CD8 降低差异有非常显著意义 (P <0 0 1) ;T淋巴细胞的异常改变与HBVDNA、PTA以及脾脏大小关系不明显。而各项观察的临床、病理指标与CD3 T淋巴细胞、B淋巴细胞均无明显相关性。结论　小儿慢性乙型肝炎患者机体存在细胞免疫功能失衡 ,其相关性表现在肝脏炎症损伤严重程度与T淋巴细胞功能的损伤有明显的相关性 ,女性对HBV的T淋巴细胞反应比男性更有利于清除HBV ,其预后及对抗病毒和免疫调节治疗反应较好。