乙型肝炎患者免疫功能的检测及其临床意义

研究乙型肝炎患者外周血T淋巴细胞亚群、NK细胞和血清免疫球蛋白的变化及临床意义.采用流式细胞仪检测150例乙肝患者和30名健康者(对照组)外周血T淋巴细胞亚群(CD3 CD4 、CD3 CD8 )、NK细胞,免疫散射法检测血清免疫球蛋白(IgG、IgM、IgA)变化.结果表明各临床类型乙肝患者NK细胞降低,与对照组比较有显著性差异(P<0.01);慢性乙型肝炎组、慢性重型乙型肝炎组、肝硬化组外周血CD3 CD4 、CD3 CD8 T细胞均下降,其中慢性重型乙型肝炎组外周血CD3 CD8 与对照组比较有显著性差异(P<0.01),急性乙型肝炎组外周血T细胞亚群变化不明显(P>0.05);各临床类型乙型肝炎患者血清免疫球蛋白IgG、IgA随着病情的进展逐渐升高,与对照组比较有显著性差异(P<0.01).因此认为慢性乙肝患者存在细胞免疫和体液免疫功能紊乱,免疫功能的检测对乙肝的诊断、治疗及预后的判断有着一定临床意义.

Detection and Implication of Immune Function in Patients with Hepatitis B

To study the changes of T-lymphocyte subsets,NK cells and serum immunoglobulin in patients with hepatitis B,the T-lymphocyte subsets and NK cell quantity were detected by flow cytometry and serum immunoglobulin by immune nephelometry in 150 patients with hepatitis B and 30 cases of healthy controls.The results showed that the numbers of NK cells in patients with hepatitis B was lower than that of control(P<0.01).The numbers of CD3 CD4 and CD3 CD8 in patients with chronic hepatitis,chronic severe hepatitis and liver fibrosis were decreased.The numbers of CD3 CD8 in patients with chronic severe hepatitis was significantly lower than that of normal group(P<0.01).There was no significant change in acute hepatitis B compared with normal group(P>0.05).The serum levels of IgG and IgA in patients with chronic hepatitis,chronic severe hepatitis and liver fibrosis were significantly increased compared with normal controls(P<0.01).The immune function was disturbed in patients with hepatitis B.The detection of the immune function has clinical significance in the diagnosis,treatment and predict prognosis of hepatitis B.