血浆置换对慢性重型乙型肝炎T淋巴细胞亚群的影响及其意义

目的探讨血浆置换对慢性重型乙型肝炎（CSHB）患者T淋巴细胞亚群的影响及其意义。方法用FACSCalibur流式细胞仪检测26例CSHB患者血浆置换前后和47例慢性乙型肝炎（CHB）的外周血T淋巴细胞总数及其亚群比例，并比较CSHB患者存活组和死亡组T淋巴细胞总数及其亚群比例的变化。结果治疗前的CSHB组T淋巴细胞总数及CD4^＋比例显著低于CHB组，而CD8^＋比例显著高于CHB组，均P〈0．01。CSHB组经血浆置换治疗后存活率为53．85％（14／26），存活组治疗后T细胞总数和CD4^＋比例较治疗前及死亡组治疗后水平升高，而CD8^＋T细胞比例则较治疗前和死亡组治疗后水平显著下降（P〈0．05）。结论血浆置换治疗可改善慢性重型乙型肝炎患者的免疫功能紊乱，并且免疫功能的检测可能有助于疗效和预后的判断。

Effect and significance of plasma exchange on T lymphocyte subsets in chronic severe hepatitis patients infected with HBV

Objective To evaluate the effect and significance of plasma exchange on T-Lymphocyte sub-sets in chronic severe hepatitis patients infected with HBV (CSHB).Methods We recruited 26 cases of CSHB treated with plasma exchange and 47 cases of chronic HBV hepatits (CHB) in this study.The total number and percentage of T-lymphocyte subsets in peripheral blood before and after plasma exchange were detected in CSHB and CHB patients by a FACSCalibur flow cytometer.The differences between CSHB and CHB patients and be-tween recover group and death group in CSHB patients were analyzed.Results Total number of T-lymphocytes and percentage of CD4 cells were significantly lower,and percentage of CD8 cells was significantly higher in CSHB patients than in CHB patients (P<0.01).In CSHB patients,the survival rate in the 3 months after plasma ex-change was 53.85% (14/26).In survival CSHB patients after plasma exchange,the total number of T-lymphocytes and percentage of CD4 cells were significantly higher,and percentage of CD8 cells was significantly lower than those before the treatment and those in death patients after plasma exchange (P<0.05).Conclusion The derange-ment of immune function in CSHB patients can be improved by plasma exchange.The examination of immune function is helpful for the evaluation of prognosis and therapeutic effects in CSHB patients.