晚期血吸虫病患者肝内T细胞亚群的免疫组织化学检测

采用免疫组织化学技术检测了２２例晚期血吸虫病（下称晚血）患者肝内Ｔ细胞亚群。发现晚血患者肝内Ｔ细胞可集中分布于虫卵肉牙中外层或者菜知分布于非肉芽肿部位的虫卵附近，广泛纤维化的区域无Ｔ细胞浸润。肉芽肿和非肉芽肿部位的Ｔ细胞均以ＣＤ８＾＋Ｔ细胞（抑制性／细胞毒Ｔ细胞）为主。晚血患者肝脏病变以汇管区纤维化主，浸润细胞不多，仅２７．２７％（６／２２）患者肝内存在已被免疫调节了的慢性虫卵肉芽肿。提示晚血患者     

晚期血吸虫病患者肝内T细胞亚群的免疫组织化学检测

采用免疫组织化学技术检测了22例晚期血吸虫病（下称晚血）患者肝内T细胞亚群。发现晚血患者肝内T细胞可集中分布于虫卵肉芽肿外层或者散在分布于非肉芽肿部位的虫卵附近，广泛纤维化的区域无T细胞浸润。肉芽肿和非肉芽肿部位的T细胞均以CD8 T细胞（抑制性／细胞毒T细胞）为主。晚血患者肝脏病变以汇管区纤维化为主，浸润细胞不多，仅27．27％（6／22）患者肝内存在已被免疫调节了的慢性虫卵肉芽肿。提示晚血患者肝内细胞免疫反应很弱，肝内的CD 8T细胞可能主要是抑制性T细胞（Ts）。     

血吸虫病虫卵肉芽肿与肝纤维化的动态观察

目的:从形态学和血清学角度探讨血吸虫病虫卵肉芽肿与肝纤维化之间的关系.方法:用血吸虫尾蚴感染新西兰家兔,建立血吸虫病动物模型.采用石蜡切片、HE染色动态观察日本血吸虫病急性期、慢性期、晚期肝脏虫卵肉芽肿大小,放射免疫检测仪测定不同时期的血清中透明质酸(hyaluronic acid,HA)含量的变化.结果:感染第6周家兔肝脏出现虫卵肉芽肿,第12周肉芽肿缩小,周围发现成纤维细胞,至第21周时虫卵肉芽肿明显缩小,肝脏纤维化程度增高,并有纤维组织增生.同时,血清HA含量检测显示随感染时间延长,体内HA水平逐渐升高.结论:血吸虫病是一个持续进展的过程,包含虫卵肉芽肿与肝脏纤维化两大病理变化,两者间发病机制不同,肝纤维化是虫卵肉芽肿的间接延伸.     

α干扰素治疗小鼠日本血吸虫病肝纤维化实验研究

目的观察IFN-α是否具有抗日本血吸虫病肝纤维化的作用及疗效.方法以日本血吸虫尾蚴感染IcR小鼠造成肝纤维化模型.10周后顿服吡喹酮杀虫治疗,继以IFN-α皮下注射治疗,并与模型对照组和0.9%氯化钠注射液治疗组比较.肝脏组织切片作苏木素-伊红、苦味酸-酸性品红染色,观察肝脏虫卵肉芽肿平均大小、胶原面积百分比及肝纤维化程度（SSS评分）.结果IFN-α治疗组肝脏虫卵肉芽肿平均大小缩小（P〈0.05）、胶原面积百分比降低（P〈0.05）、SSS评分较模型对照组下降〉2分（P〈0.05）.结论IFN-α治疗小鼠日本血吸虫病肝纤维化有效.     

马洛替酯对晚期血吸虫病小鼠肝脏虫卵肉芽肿的影响

马洛替酯对晚期血吸虫病小鼠肝脏虫卵肉芽肿的影响汪雁南邵勤潘炳荣李洪（寄生虫学教研室南昌３３０００６）马洛替酯（ｍａｌｏｔｉｌａｔｅ）是治疗肝病的新药，用于治疗慢性活动性肝炎及肝炎后肝硬化已初具疗效［１］。晚期血吸虫病（简称晚血）肝纤维化的治疗是血防工...     

Tim-2在日本血吸虫感染小鼠Th2优势应答中的作用

目的观察日本血吸虫感染小鼠T细胞免疫球蛋白黏蛋白分子-2(Tim-2)基因表达与干扰素-γ(IFN-γ)、白细胞介素-4(IL-4)水平的动态变化,探讨Tim-2在血吸虫感染小鼠Th1/Th2免疫平衡中的可能机制。方法以日本血吸虫尾蚴感染小鼠,采用RT-PCR、ELISA法检测不同感染阶段小鼠脾淋巴细胞中Tim-2和IFN-γ、IL-4水平;HE染色观察组织学改变;免疫组化法检测Tim-2在肝脏虫卵肉芽肿中的表达。结果日本血吸虫尾蚴感染后3周小鼠脾淋巴细胞IFN-γmRNA及其培养上清中蛋白表达水平均显著增高(P<0.01);而IL-4 mRNA及其培养上清中蛋白表达水平于感染6周、9周显著增高(P<0.01);HE染色显示随着血吸虫感染进程的发展,肝脏肉芽肿面积逐步增大,6周达峰值,随后有所下降;RT-PCR结果显示尾蚴感染6周的小鼠脾细胞中Tim-2基因表达较正常对照组显著增高;免疫组化法分析显示,小鼠肝脏虫卵肉芽肿Tim-2表达主要分布在虫卵及其周围。结论慢性血吸虫感染可诱导宿主全身性的Th2优势应答,Tim-2可能参与慢性感染宿主机体Th1/Th2免疫平衡的调节。     

HMGB1在日本血吸虫病小鼠肝脏虫卵肉芽肿组织中的表达

目的：：确定日本血吸虫病小鼠肝脏虫卵肉芽肿形成过程中 HMGB1的表达。方法：建立日本血吸虫病小鼠模型,免疫组织化学方法检测肝脏虫卵肉芽肿形成过程中 HMGB1的表达,半定量方法测定 HMGB1表达的累积光密度值(IOD),ANOVA 统计分析各组之间差异。结果：未感染日本血吸虫尾蚴的对照组小鼠肝脏与感染尾蚴后2、4、6周模型组小鼠肝脏虫卵肉芽肿组织中 HMGB1表达差异有显著性(F =526.30,P <0.05),除感染尾蚴后4、6周的模型组差异不具有显著性(t =1.574,P =0.1162)外,其余各组差异均具有显著性(P <0.05)。结论：HMGB1可能参与日本血吸虫病小鼠肝脏虫卵肉芽肿的形成过程。     

血吸虫病免疫病理研究进展

血吸虫病主要病理变化是宿主肝组织内虫卵的沉积诱发虫卵肉芽肿及其后的纤维化病变.在动物模型的相关研究已显示Th1细胞主要参与血吸虫虫体抗原的免疫调节反应,而虫卵衍生抗原主要介导Th2细胞免疫反应.研究证明Th1细胞、Th2细胞、巨噬细胞、Treg细胞和IL-17分泌型淋巴细胞对调节虫卵肉芽肿反应和肝脏的纤维化过程起重要作用.     

聚合酶链反应对晚期血吸虫病患者合并HBV及HCV感染的检测及其意义

聚合酶链反应（PCR）是高度敏感和特异的检测方法，已用于HBV及HCV感染的临床及基础研究。本文采用PCR技术对102例晚期日本血吸虫病巨脾型患者（下称晚血）的血清及肝组织进行了HBV—DNA及HCV－RNA检测，并对患者作了随访观察，现将结果报道如下：材料与方法1研究对象本级102例中男性68例，女性34例，平均年龄35．5±1．2岁。为1986～1992年江陵县血防所住院患者，符合卫生部地方病防治司公布的巨脾型晚血临床诊断标准[1]，并经肝组织病理检查确诊。所有患者肝内均有虫卵或虫卵结节，汇管区纤维组织增生呈干线型变宽和炎性细胞浸…     

雷公藤煎剂对小鼠肝脏日本血吸虫卵肉芽肿形成的影响

本文报道雷公藤对感染日本血吸虫小白鼠肝虫卵肉芽肿的影响。结果显示实验组肝单卵和多卵肉芽肿直径均明显小于对照组:肉茅肿内浆细胞和嗜酸性粒细胞极为罕见;平均每对成虫排入肝内的虫卵数少于对照组。表明雷公藤对日本血吸虫病鼠肝虫卵肉芽肿的形成有明显抑制作用。     

晚期日本血吸虫病合并HBV感染的临床和病理研究

采用双桥PAP法检测155例晚期血吸虫病(晚血)患者肝内HBsAg和HBcAg,结果88例(56.8％)HBsAg或(和)HBcAg阳性,肝内HBAg阳性组的肝脏病理变化和临床表现显著比阴性组严重,晚血患者发生的门脉性肝硬化大多数与合并HBV感染有关。提示合并HBV感染可以明显加重晚血患者的临床表现和肝脏病变,甚至是晚血患者发生门脉性肝硬化的主要原因。     

Immunohistochemical detection of HBsAg and HBcAg in the liver of patients with schistosomiasis japonica complicated by hepatocellular carcinoma

Summary In liver biopsies from 21 patients with schistosomiasis japonica complicated by hepatocellular carcinoma (HCC), 69 patients with advanced schistosomiasis japonica, and 25 patients with HCC, HBsAg and HBcAg were investigated with peroxidase-antiperoxidase technique. The positive rate of HBAg (i.e. HBsAg and/or HBcAg) in the liver of patients with schistosomiasis japonica complicated by HCC was significantly higher than in the group of advanced schistosomiasis japonica, but similar to that in cases of HCC. The location of carcinoma cells in the liver was not related to the distribution of schistosomial ova in patients with schistosomiasis japonica complicated by HCC. The results indicated that the complication with hepatitis B virus infection may be one of the major factors involved in the development of HCC in patients with schistosomiasis japonica.     

Detection of HBAg in the liver in patients with schistosomiasis complicated by liver carcinoma

HBsAg and HBcAg were detected in the liver biopsies of 21 patients with schistosomiasis japonica complicated by hepatocellular carcinoma (HCC), 69 patients with advanced schistosomiasis japonica and 25 patients with HCC. The positive rate of HBAg in liver of patients with schistosomiasis complicated by HCC (85.7%) was significantly higher than those with advanced schistosomiasis (56.5%), but similar to that in the group of HCC (80.0%). The location of tumor cells in liver was not related with the distribution of schistosomal ova in patients with schistosomiasis complicated by HCC. The results indicate that complicated HBV infection may be one of the major causes of HCC developed in patients with schistosomiasis japonica.     

慢性血吸虫感染患者外周血单核细胞体外诱生IL-1水平的检测

本文检测了14例慢性血吸虫病(下称慢血)和19例晚期血吸虫病(下称晚血)患者外周血单核细胞体外经脂多糖诱生白细胞介1(IL-l)的活性。结果慢血和晚血患者的IL-1水平分别为75.63±13.80U和57.18±14.33U,均显著低于对照组(98.58±22.13U),经消炎痛处理,可提高两组患者的IL-1诱生水平。提示IL-1水平降低可能是慢性血吸虫感染患者细胞免疫功能降低的重要机制之一。     

Changes in T cell subsets and T suppressor cell function and their relationship in human schistosomiasis japonica

Summary The function of spontaneous T suppressor cell (STs) of peripheral blood was examined in 56 patients with schistosomiasis japonica at various stages. The subsets of T cell were simultaneously phenotyped in 46 cases. The percentages of CD₃ ⁺(pan T cell), CD₄ ⁺ (helper/inducer T cell) and CD₈ ⁺ (suppressor/cytotoxic T cell) in patients with acute schistosomiasis japonica were significantly higher than those in the normal controls. In patients with chronic and advanced schistosomiasis japonica, the percentage of CD₈ ⁺ T cell and the function of STs were greatly increased, but the percentage of CD₃ ⁺ T cell and the ratio of CD₄ ⁺/CD₈ ⁺ were obviously reduced. All of these markers changed more significantly in patients with advanced schistosomiasis japonica. The percentage of CD₈ ⁺ T cell in patients with acute schistosomiasis japonica was negatively correlated with the function of STs. In patients with chronic and advanced schistosomiasis japonica the percentage of CD₈ ⁺ T cell was correlated positively and the ratio of CD₄ ⁺/CD₈ ⁺ negatively with the function of STs. The results indicated that the cellular immunity was significantly increased in cases of acute schistosomiasis japonica and decreased in those with chronic or advanced schistosomiasis japonica. The increased CD₈ ⁺ T cell may be principally cytotoxic T cells in patients with acute schistosomiasis japonica, but suppressor T cells in patients with chronic and advanced schistosomiasis japonica. The subsets of T cells and the function of T suppressor cells may play an important role in the immunoregulation of schistosomiasis japonica.     

慢性血吸虫感染患者自发性抑制性T细胞功能和T细胞亚群的改变及其相互关系

检测了14例慢性血吸虫病(下称慢血)和25例晚期血吸虫病(下称晚血)患者外周血自发性抑制性T细胞(STs)功能,对所有慢血患者和15例晚血患者同时检测外周血T细胞亚群。结果慢血和晚血患者STs功能均显著增高,CD~+_3(全T细胞)百分比和CD~+_4(辅助性T细胞)/CD~+_8(抑制性/细胞毒T细胞)比值明显降低,CD~+_8细胞百分比升高,CD~+_8细胞百分比和CD~+_4/CD~+_8比值分别与STs功能呈正相关和负相关。对STs功能和T细胞亚群在慢性血吸虫感染免疫调控中的作用进行了讨论。     

Changes in the level of IL-2, T cell subsets and the function of T suppressor cells in patients with schistosomiasis japonica

Summary The level of interleukin-2 (IL-2) produced by peripheral blood mononuclear cells in vitro, T cell subsets and the function of T suppressor cells (Ts) in patients with schistosomiasis japonica were investigated. It was found that the level of IL-2 induced by schistosomal antigens was significantly high and positively related to the percentage of CD4⁺ cells. In the groups of chronic and advanced schistosomiasis japonica, the level of IL-2 induced by schistosomal antigens was markedly lower than that in the group of acute schistosomiasis japonica, but significantly higher than that in the group of normal controls. The IL-2 level was negatively related to the percentage of CD8⁺ T cells and the ratio of CD4⁺/CD8⁺. The level of IL-2 induced by PHA was greatly reduced in the group of advanced schistosomiasis japonica. The changes in the level of IL-2 and its relationship with T cell subsets and the function of Ts are also discussed.     

血吸虫病患者外周血IL-2水平、T细胞亚群和抑制性T细胞功能的改变

检测了各期血吸虫病患者外周血单个核细胞体外诱生IL-2的水平、T细胞亚群和抑制性T细胞(Ts)功能。急性组由血吸虫抗原诱生出高水平的IL-2,CD_3~+、CD_4~+和CD_8~+T细胞百分比均显著升高,其中IL-2水平与CD_4~+T细胞百分比呈正相关;慢性和晚期组由血吸虫抗原诱生的IL-2水平显著低于急性组,但明显比对照组高,CD_3~+T细胞百分比和CD_4~+/CD_8~+比值降低,CD_8~+T细胞百分比和Ts功能升高,IL-2水平与CD_8~+T细胞百分比和Ts功能呈负相关,其中晚期组由PHA诱生的IL-2水平明显降低。     

晚期血吸虫病胃底静脉曲张无创性临床指标探索

目的探索晚期血吸虫病门脉高压所致胃底静脉曲张的无创性临床相关指标及分析其临床价值。方法收集120名晚期血吸虫病住院患者电子胃镜、腹部B超、外周血象、肝功能等临床指标,应用单因素及Logistic回归法分析腹部B超和外周血象等无创性指标与晚期血吸虫病门脉高压所致胃底静脉曲张的关系。结果单因素分析显示血红蛋白、红细胞、APTT、脾静脉内径、总蛋白、白蛋白、血钠以及肝功能分级与有无胃底静脉曲张存在显示出显著性意义(P<0.05),表明这些指标为胃底静脉曲张存在的无创性临床指标,经多因素Logistic回归分析显示总蛋白以及血钠最有临床价值,偏回归系数B分别为1.30、1.02(P=0.03、0.02),总蛋白与血钠的危险度比值exp(B)分别为3.68、2.76。结论总蛋白及血钠是预测晚期血吸虫病人胃底静脉曲张是否存在的最有意义的指标,可作为临床上诊断晚期血吸虫病胃底静脉曲张的临床诊断参考。