慢性乙型肝炎虚实病机与病毒复制及T细胞关系的研究

目的：通过对虚实分类的慢性乙型肝炎(乙肝)患者进行乙肝病毒DNA(HBV—DNA)定量、T淋巴细胞亚群检测分析，探讨中医虚实病机与现代医学免疫发病机制之间的关系。方法：将HBeAg阳性的慢性乙肝轻、中度的患者分为虚证组、实证组、虚实夹杂组，检测上述指标并对各组进行比较分析。结果：与正常对照组比较，各组慢性乙肝患者CD4^ 水平明显下降，CD4^ /CD8^ 存在明显差异。HBV—DNA定量实证组＞虚实兼夹组＞虚证组(P＜0．05)。CD4^ ／CD8^ 比值虚证组＞虚实兼夹组＞实证组(P＜0．05)。结论：慢性乙肝患者存在着免疫调节紊乱;HBV—DNA定量水平可作为实证的参考指标，CD4^ ／CD8^ 值可作为虚实变化的参考指标，CD8^ 可能是虚证的参考指标。

Relation between pathogenesis of traditional Chinese medicine and hepatitis B virus-DNA or T lymphocytes in chronic hepatitis B

Objective :To provide objective indexes for clinical syndrome differentiation in patients with chronic hepatitis B, and research the relation between pathogenesis and hepatitis B virus (HBVDNA) or T lymphocytes. Methods: The eligible patients with slight and moderate chronic hepatitis B, HBeAgpositive and detectable copy of HBVDNA in serum were divided into sthenia syndrome group, intermingled asthenia and sthenia syndrome group and asthenia syndrome group. The indexes were analyzed in research groups. Results: Compared to controls, level of CD + 4 cell in patients with chronic hepatitis B decreased, while there was a significant difference in level of CD + 4/CD + 8 ratio. The levels of HBVDNA were SS>IASS>AS( P <0 05). The level of CD + 4/CD + 8 ratio was AS>IASS>SS( P <0 05). Conclusion: It is suggested that there is disorder in immune regulation in hepatitis B patients. The levels of HBVDNA could be regarded as the index of SS. The proportion of CD + 8 could be regarded as the index of AS. The value of CD + 4/CD + 8 could be regarded as the index of IASS.