慢性乙型肝炎外周血T淋巴细胞亚群变化的Meta分析

目的:系统评价慢性乙型肝炎(CHB)患者外周血T淋巴细胞(TC细胞)亚群的变化情况及与乙型肝炎病毒脱氧核糖核酸(HBV-DNA)的关系。方法:通过计算机检索2000年1月1日至2013年12月31日公开发表于Medline(检索平台PubMed)、Embase(检索平台Ovild)、Central(检索平台Ovild)、维普、万方、知网等数据库所有关于CHB患者外周血TC细胞亚群变化的相关中英文文献。由2位评价人员按照纳入与排除标准独立筛选文献、提取资料和评价纳入研究的方法学质量后,采用RevMan 5.3软件进行Meta分析。结果:CHB患者外周血CD3+、CD4+T细胞和CD4+/CD8+比值均低于健康人群(P<0.01),而CHB患者外周血CD8+T细胞百分率高于健康人群(P<0.01)。HBeAg阳性组与HBeAg阴性组比较,外周血CD4+T细胞百分率显著降低,CD8+T细胞百分率显著升高(P<0.01),CD4+/CD8+差异无统计学意义(P>0.05)。HBV-DNA阳性组与HBV-DNA阴性组比较,外周血CD3+、CD4+T细胞百分率和CD4+/CD8+均显著降低(P<0.01),而CD8+T细胞百分率显著升高(P<0.01)。HBV-DNA定量高拷贝组与HBV-DNA定量低拷贝组比较,外周血CD4+T细胞百分率和CD4+/CD8+显著降低(P<0.01),而CD8+T细胞百分率升高(P<0.05);2组CD3+T细胞百分率差异无统计学意义(P>0.05)。结论:CHB可导致人体外周血TC细胞亚群的改变,其变化与HBV-DNA含量呈相关性。

Meta-analysis of T-lymphocyte subsets change in peripheral blood of patients with chronic hepatitis B

Objective:To analyze the T-lymphocyte subsets change in peripheral blood of patients with chronic hepatitis B( CHB) ,and its correlation with hepatitis B-deoxyribonucleic acid( HBV-DNA) . Methods:The relative literatures of T-lymphocyte subsets change in peripheral blood of patients with CHB from Medline ( PubMed retrieval platform ) , Embase ( Ovild retrieve platform ) , Central ( Ovild retrieval platform),Whip,Wanfang and CNKI from January 1,2000 to December 31,2013 were searched. Independent screening documents,extracting information and evaluation were implemented independently by 2 evaluators according to the inclusion and exclusion criteria,which was analyzed by Meta using RevMan 5. 3 software. Results:The percentage of CD3 +T,CD4 +T and CD4 + T/CD8 + T in patients with CHB were lower than those in healthy people,but the percentage of CD8 +T cells of patients was higher( P<0. 05). Compared with the HBeAg( -) patients,the percentage of CD4 + T and CD8 + T decreased and increased significantly in HBeAg( +) patients,respectively(P<0. 01),the difference of CD4 + T/CD8 + between HBeAg( -) and HBeAg( +) patients was not statistical significance (P>0. 05). Compared with the negative HBV DNA patients,the percentage of CD3 +T,CD4 + T and CD4 +T/CD8 +T, and percentage of CD8 + T decreased and increased significantly in the positive HBV DNA patients, respectively ( P <0. 01). Compared with the low copies of HBV DNA patients,the percentage of CD4 + T and CD4 +T/CD8 +T and percentage of CD8 + T decreased and increased significantly in high copies of HBV DNA patients,respectively(P <0. 01),the difference of percentage of CD3 + T between the low and high copies of HBV DNA patients was not statistical significance(P>0. 05). Conclusions:HBV infection can lead to the change of T cell subsets of patients,which is positively related to the HBV-DNA level.