慢性乙型肝炎病毒感染者外周血CD4＋CD25＋CD127low／-调节性T淋巴细胞表达水平及其与肝脏病理关系

目的探讨CD4＋、CD25＋、CDl27low/-调节性T淋巴细胞（Treg）在慢性HBV感染者外周血中的表达水平及其与肝脏病理的关系。方法采用流式细胞术检测70例慢性HBV感染者和40例健康体检者外周血CD4＋、CD25＋、CD127low/-Treg的表达水平，对70例HBV感染者在B超引导下行肝穿刺病理检查，同时行HBV相关血清学检查。组间差异比较采用独立样本t检验，各组数据间的相关性采用Spearman或Pearson直线相关分析。结果70例慢性HBV感染者ALT水平为（35．564-10．42）U／L，其中ALT〈40U／L者50例，HBeAg阳性40例，HBeAg阴性30例。70例慢性HBV感染者CD4＋、CD25＋、CD127low／-Treg水平为（5．55±1．20）％，健康对照组为（4．85±0．86）％，两组差异有统计学意义（t=2．191，P=0．003）。慢性HBV感染者外周血CD4＋、CD25＋、CD127low/-Treg水平与HBVDNA栽量呈正相关（r=0．495，P=0．003）。肝组织炎症活动度（G）≤2的患者62例，外周血CD4’、CD25’、CD127low/-Treg表达水平为（5．80±1．14）％，高于8例G＞2患者的（4．00±0．67）％，两者比较差异有统计学意义（t=2．425，P=0．002）。肝组织纤维化分期（S）〈2的患者48例，外周血CD4＋、CD25＋、CD127low/-Treg水平为（6．00±1．34）％，高于22例S≥2者的（4．70±1．02）O，两者比较差异有统计学意义（t=2．559，P=0．001）。慢性HBV感染者外周血CD4叶。、CD25’、CD127low/-Treg水平与炎症活动度分级呈负相关（r=-0．539，P=0．001），与纤维化分期亦呈负相关（r=-0．488，P=0．003）。结论CD4＋、CD25＋、CD127low/-Treg与乙型肝炎的病情慢性化、肝组织损伤有关，可能在疾病的发生、发展和转归中发挥重要的调节作用。

Association of peripheral CD4+CD25+CD127low/-regulatory T cells and liver pathology in chronic hepatitis B virus-infected individuals

Objective To explore the expression level of CD4＋ CD25＋ CD127low/-regulatory T cells （Treg） in the peripheral blood of chronic hepatitis B virus （HBV） infected individuals, and its association with liver pathology. Methods 70 chronic HBV-infected individuals and 40 healthy controls were enrolled. The frequencies of peripheral blood CD4＋CD25＋ CD127low/- Treg were detected by flow cytometry. HBV-related serological tests as well as ultrasoundguided liver biopsies were performed in chronic HBV-infected individuals. Spearman and Pearson correlation analyses were performed. Results The alanine aminotransferase （ALT） level of chronic HBV-infected individuals waz （35.56 5： 10. 42） U/L, with fifty subjects of ALTO40 U/L. Forty subjects were hepatitis B e antigen （HBeAg） positive, and thirty were HBeAg negative. The frequency of the peripheral blood CD4＋ CD25＋ CD127low/- Treg in chronic HBV-infected individuals was （5.58±1.20）%, which was significantly higher than that in healthy controls （4.85 4±0.86）%;t= 2. 191, P=0. 003]. The level of peripheral blood CD4＋ CD25＋ CD127low/- Treg was positively correlated with HBV viral load （r=0. 495, P=0. 003）. Sixty-two subjects had liver inflammatory score 42, with a peripheral blood CD4＋ CD25＋ CD127low/- Treg level of （5.80±71.14）%, which was significantly higher than that of the rest eight subjects who had liv- er inflammatory score 〉2 （4. 00-4-0. 67）%; t= 2. 425, P= 0. 002]. Forty-eight subjects had liver fibrosis score〈（2, with a peripheral blood CD4＋ CD25＋ CD1271ow/- Treg level of （6.00± 1.34）%, which was significantly higher than that of the rest twenty-two subjects who had liver fibrosis score ≥2 （4.70±1.02）%; t=2. 559, P=O. 001]. The exores-sion of CD4＋ CD25＋ CD127low/- 0. 001） and fibrosis （r - Treg in peripheral blood was inversely correlated with liver inflammation （r=-0. 539, P=0. 488, P = 0. 003） in chronic HBV-infected individuals. Conclusion CD4＋ CD25＋ CD127low/-