辅助性T细胞17及调节性T细胞在慢性乙型肝炎患者外周血的变化及意义

目的 探究辅助性T细胞17及调节性T细胞在慢性乙型肝炎病毒感染患者外周血的变化及意义。方法 以2016年5月—2017年5月在深圳市龙华区中心医院肝病房收治的120例慢性乙型肝炎病毒感染患者为研究对象,根据慢性乙型肝炎诊断标准分为轻、中、重度三组患者,其中轻度患者31例,中度患者48例,重度患者41例,同时选取本院60例健康体检者作为对照组。采用流式细胞仪对辅助性T细胞17（Th17）及调节性T细胞(Treg)进行监测,同时对各组患者的肝功指标:血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)进行检测,对四组患者的以上指标进行比较分析。结果 中度组ALT和AST的含量要高于轻度组,差异存在统计学意义（t=8.264、10.237,P<0.05）,重度组ALT和AST要高于中度组,差异存在统计学意义（t=11.036、17.209,P<0.05）。中、重度组乙型肝炎病毒感染者的Th17表达率均要高于健康对照组（t=16.230、18.714,P<0.05）;各感染组的Th17表达率差异存在统计学意义（F=22.783,P<0.05）;轻、中和重度组感染乙肝病毒的患者Treg表达率要高于健康对照组（t=3.201、3.784、4.115,P<0.05）,而不同程度地感染乙型肝炎的各组之间无差异（P>0.05）; 轻、中和重度组感染乙肝病毒的患者Th17/Treg 比值要高于健康对照（t=21.306、24.397、28.001,P<0.05）,且不同程度地感染乙型肝炎的各组之间差异存在统计学意义（F=35.067,P<0.05）。结论 慢性乙型肝炎病毒感染的患者随着病情的发展Th17和Treg细胞水平会呈现一定的上升趋势,Th17/Treg比值较单一的 Th17、Treg 表达率更能反映肝脏受侵害的病情发展。

Changes and significance of T helper type 17 cells and regulatory T cells in peripheral blood of patients with hepatitis B virus

Objective To investigate the changes and significance of T helper type 17 cells and regulatory T cells in peripheral blood of patients with hepatitis B virus infection. Methods Totally 120 patients with chronic hepatitis B treated in Longhua Central Hospital from May 2016 to May 2017 were divided into three groups according to the diagnostic criteria of hepatitis B: mild, moderate and severe, including 31 cases in the mild group, 48 cases in the moderate group and 41 cases in the severe group, and at the same time, 60 patients of health examination in our hospital were selected as control group. The T helper 17 cells (Th17) and regulatory T cells (Treg) were monitored by flow cytometry. The liver function of patients in each group: the serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) of patients were detected and the above indexes were compared and analyzed among the four groups. Results The contents of ALT and AST in the moderate group were significantly higher than those in the mild group, and there were statistically significant differences（t=8.264, 10.237,P<0.05）. The contents of ALT and AST in severe group were significantly higher than those in the moderate group, and there were statistically significant differences（t=11.036, 17.209,P<0.05）. The expression rate of Th17 in patients with hepatitis B virus infection in the moderate and severe groups were significantly higher than that in the healthy control group（t=16.230, 18.714,P<0.05）. There was a significant difference in the expression rate of Th17 among the infected groups and there were statistically significant differences （F=22.783,P<0.05）. The expression rate of Treg in patients with hepatitis B virus infection in mild, moderate and severe groups were significantly higher than that in the healthy control group（t=3.201, 3.784, 4.115,P<0.05）, and there was no difference among the groups with different degrees of hepatitis B virus infection (P>0.05). The expression rate of Th17/Treg in patients with hepatitis B virus infection in mild, moderate and severe groups were significantly higher than that in the healthy control group （t=21.306, 24.397, 28.001,P<0.05）, and there was a statistically significant difference among groups with different degree of hepatitis B infection（F=35.067,P<0.05）. Conclusion With the development of the disease in patients with hepatitis B virus infection, the levels of Th17 and Treg cells show an upward trend. Compared with the expression rate of Th17 and Treg, the ratio of Th17/Treg more Objectively shows the development of the condition of the liver invasion.