肝硬化患者外周血CD19+ CD25+细胞表达的临床意义

探讨肝硬化患者外周血CD19＋ CD25＋双阳性细胞表达的临床意义.采用流式细胞仪检测70例肝硬化患者和20例健康对照者外周血CD19＋ CD25＋细胞、T淋巴细胞以及B淋巴细胞的表达,免疫比浊法检测血清免疫球蛋白（IgG、IgM、IgA）水平.肝硬化患者外周血CD＋3、CD＋3 CD＋8细胞表达率和CD＋3、CD＋3 CD4＋、CD＋3 CD＋8细胞绝对数明显低于对照组（P均＜0.01）;而CD＋3 CD4＋/CD＋3 CD＋8比值、CD19＋、CD19＋ CD25＋细胞表达率以及免疫球蛋白（IgG、IgM、IgA）水平显著增高（P均0.05）.肝硬化患者CD19＋ CD25＋细胞表达率与ALT、IgG、IgA呈正相关（r为0.548、0.541、0.334,P均＜0.05）.食管胃底静脉曲张组CD＋3、CD＋3 CD4＋细胞绝对数以及CD＋3 CD＋8细胞表达率和绝对数明显低于未曲张组（P均＜0.01）;而CD＋3 CD4＋细胞表达率、CD＋3 CD4＋/CD＋3 CD＋8比值、免疫球蛋白（IgM、IgA）水平高于未曲张组（P均＜0.01）.肝硬化患者Child-Pugh分级越差,CD19＋ CD25＋细胞表达率和IgG、IgM、IgA水平明显升高（P均＜0.01）,而CD＋3、CD＋3 CD4＋、CD＋3 CD＋8细胞绝对数明显降低（P均＜0.05）.检测肝硬化患者外周血CD19＋ CD25＋细胞表达水平能反映患者的肝脏损伤程度和体液免疫状况,有助于指导临床治疗和预后判断.

Clinical significance of measurement of CD19+ CD25+ cells in peripheral blood from patients with hepatic cirrhosis

To investigate the clinical significance of CD19 CD25 cells in peripheral blood from patients with hepatic cirrhosis. Expression levels of CD19 CD25 cells, T - lymphocyte subsets and B - lymphocytes in peripheral blood from 70 patients with hepatic cirrhosis and 20 control donors were measured by flow cytometry (FCM). And immunoglobulin (Ig) (IgG, IgM and IgA) were detected by Coulter - Immage nephelonereic analyzer. As compared with those in control donors, the expression of CD3 cells, CD3 CD8 cells and the number of CD3 , CD3 CD4 and CD36 CD8 were obviously lower ( P>0. 001 ). While the ratio of CD3 CD4 /CD3 CD8 , the expression of CD19 , CD19 CD25 and the level of serum Ig were significantly higher (P <0. 05). There was positive correlation between the expression rate of CD19 CD25 and the level of ALT, IgG and Ig A( r = 0. 548 ,0. 541 ,0. 334 P < 0. 01 respectively). Compared with patients without esophagus varix, patients with e-sophagus rarix had a less number of CD3 , CD3 CD4 and CD3 CD8 and higher level of Ig (IgM and IgA) (P < 0. 01 ). With the lower Child - Pugh grading, the expression of CD19 CD25 and the level of Ig were higher, and the number of CD3 , CD3 CD4 and CD3 CD8 cells were smaller (P<0. 05). The expression of CD19 CD25 cells in peripheral blood in patients would reflect degree of liver injury and status of humoral immunity, that may be helpful to instruct clinical therapy and judge the prognosis.