尖锐湿疣患者HPV感染与细胞免疫功能的相关性

目的研究尖锐湿疣初发、复发患者之间,以及不同病程患者之间T淋巴细胞亚群的表达情况。方法选择56例尖锐湿疣患者,经冷冻治疗后至疣体消失后随访3个月,未复发者计入A组(20例),再次复发者计入B组(36例),应用三色荧光抗体染色法检测各组患者外周血CD4+,CD8+T淋巴细胞的表达,比较A,B两组CD4+,CD8+T细胞百分率及CD4+/CD8+比值的差异,并与正常对照组进行比较。同时根据病程长短,病程<3个月者计入C组(37例),病程≥3个月者计入D组(19例),比较C,D两组CD4+,CD8+T细胞百分率及CD4+/CD8+比值的差异,并与正常对照组进行比较。结果①初发及复发患者组T淋巴细胞亚群的变化:A组CD4+,CD8+T细胞百分率及CD4+/CD8+比值分别为(34.61±4.98)%,(29.46±4.56)%和(1.20±0.22),B组分别为(30.33±4.84)%,(33.10±5.90)%和(0.94±0.21),正常对照组分别为(39.58±4.31)%,(25.44±3.54)%和(1.57±0.17),与正常对照组相比,A,B两组CD4+细胞百分率及CD4+/CD8+比值明显降低,CD8+T细胞百分率明显升高,差异有统计学意义(P<0.05),且B组变化更为明显,与A组差异有统计学意义(P<0.05);②不同病程患者组T淋巴细胞亚群的变化:C组CD4+,CD8+T细胞百分率及CD4+/CD8+比值分别为(33.03±4.51)%,(30.60±5.36)%和(1.11±0.23),D组分别为(29.57±5.98)%,(34.12±5.73)%和(0.89±0.22),C,D两组与正常对照组相比,CD4+细胞百分率及CD4+/CD8+比值明显降低,CD8+T细胞百分率明显升高,差异有统计学意义(P<0.01),且D组变化更为明显,与C组差异有统计学意义(P<0.05)。结论与正常对照组比较,尖锐湿疣患者存在细胞免疫功能降低,且随着病程延长、病情反复,全身细胞免疫功能降低更为明显,导致CA迁延不愈。

The Relationship between HPV Infection and Cell-mediated Immunity in Patients with Condyloma Acuminatum

Objective To investigate the level of peripheral blood CD4+、CD8+ T cell in the serum of patients with HPV infection. Methods A total of 56 patients with genital condyloma acuminatum(CA) within 3 months follow up after cryotherapy without any other treatment were enrolled in the study. The patients were divided into two groups according to relapse or not, including 20 cases in group A (which are not relapsed) and 36 cases in group B (which are relapsed). Additionally, the patients were according to the disease course, including 37 cases in group C (which were less than 3 months duration) and 19 cases a of group D (which were over 3 months duration). Peripheral blood samples were tested by three-color flow cytometry to assay the expression of CD4+,CD8+T cell and CD4+/ CD8+ ratio. The levels of CD4+,CD8+T cell and CD4+/ CD8+ ratio of the different groups and 15 normal human controls were analyzed. Results ①The levels of CD4+,CD8+T cell and CD4+/ CD8+ ratio were (34.61 ± 4.98)%, (29.46 ± 4.56)%,(1.20 ± 0.22)respectively in group A,(30.33 ± 4.84)%,(33.10 ± 5.90)%,(0.94 ± 0.21)respectively in group B, and (39.58 ± 4.31)%,(25.44 ± 3.54)%,(1.57 ± 0.17)respectively in normal controls. The patients’group showed lower levels of CD4+ T cell and CD4+/ CD8+ ratio than those of the controls(P < 0.05), and higher levels of CD8+T cell(P < 0.05). Moreover, comparing different patient groups, CD4+,CD8+ T cell percentages and CD4+/CD8+ ratio were significantly different (P < 0.05). ②The levels of CD4+,CD8+T cell and CD4+/ CD8+ ratio were (33.03 ± 4.51)%,(30.60 ± 5.36)%,(1.11 ± 0.23)respectively in group C, (29.57 ± 5.98)%,(34.12 ± 5.73)%,(0.89 ± 0.22)respectively in group D. T cell subpopulation in patients’groups showed lower levels of CD4+ T cell and CD4+/CD8+ ratio than those of the controls(P < 0.01), and higher levels of CD8+T-cell(P < 0.05). Moreover, comparing different patient groups, CD4+,CD8+ T cell percentages and CD4+/CD8+ ratio were significantly different (P < 0.05). Conclusion Cell-mediated immunodeficiency occured in patients with CA. There was a significant difference in cell-mediated immunity between the patients group and control group. Moreover, the course of CA, primary or relapse was associated with the cell-mediated immunity, which showed significant difference.