外周血T、B淋巴细胞亚群及Th1类细胞因子在乙肝肝硬化患者中的变化

目的 研究外周血T、B淋巴细胞亚群及Th1类细胞因子在乙肝肝硬化患者中的变化.方法 选取2015年6月至2016年10月期间深圳市第二人民医院收治的65例乙肝肝硬化患者为观察组,同时期的65名体检健康人员为对照组,检测并比较两组受检者外周血T、B淋巴细胞亚群及Th1类细胞因子水平,比较观察组患者中不同Child-pugh分级、是否伴有脾肿大患者的外周血T、B淋巴细胞亚群及Th1类细胞因子水平.结果 观察组患者的外周血T淋巴细胞亚群(CD3+、CD4+、CD3+CD4+及CD4/CD8)及CD5+、血清IL-2水平分别为(57.20±5.15)％、(35.35±3.60)％、(28.98±2.81)％、(1.23±0.12)、(63.23±5.75)％及(4.31±0.41)ng/mL,均低于对照组的(64.24±5.78)％、(42.56±4.18)％、(37.35±3.95)％、(1.78±0.21)、(70.45±6.38)％及(6.20±0.63)ng/mL,其他外周血B淋巴细胞亚群指标(CD20+、CD40L+及CD5+CD19+)及Th1类细胞因子(IFN-γ、TGF-β及TNF-α)分别为(6.84±0.45)％、(9.45±0.63)％、(5.72±0.46)％、(105.64±10.72)ng/L、(276.72±34.75)pg/mL及(1.63±0.24)ng/mL,均高于对照组的(3.31±0.25)％、(5.25±0.37)％、(2.43±0.22)％、(80.25±6.34)ng/L、(169.89±20.34)pg/mL及(0.83±0.13)ng/mL,且观察组中不同Child-pugh分级及是否伴有脾肿大患者的上述指标检测结果比较差异亦均有统计学意义(P<0.05).结论 外周血T、B淋巴细胞亚群及Th1类细胞因子在乙肝肝硬化患者中呈现明显异常表达状态,对乙肝肝硬化患者的Child-pugh分级及脾肿大均有一定的检测价值.

Change of peripheral blood T,B lymphocyte subsets and Th1-type cytokines of patients with cirrhosis caused by hepatitis B

Objective To study and observe the change status of peripheral blood T, B lymphocyte subsets and Th1-type cytokines of patients with cirrhosis caused by hepatitis B. Methods From June 2015 to October 2016, 65 pa-tients with cirrhosis caused by hepatitis B in our hospital were selected as the observation group, and 65 healthy persons with physical examination at the same time were selected as the control group. The peripheral blood T, B lymphocyte subsets and Th1-type cytokines levels were detected, and compared between two groups and also all between patient groups with different Child-pugh classifications and patient groups with or without splenomegaly. Results The periph-eral blood T lymphocyte subsets (CD3+, CD4+CD3+CD4+, and CD4/CD8) and CD5+, serum IL-2 levels of the observa-tion group were respectively (57.20 ± 5.15)％, (35.35 ± 3.60)％, (28.98 ± 2.81)％, (1.23 ± 0.12), (63.23 ± 5.75)％and (4.31 ± 0.41) ng/mL, which were all significantly lower than (64.24 ± 5.78)％, (42.56 ± 4.18)％, (37.35 ± 3.95)％, (1.78 ± 0.21), (70.45 ± 6.38)％, and (6.20 ± 0.63)ng/mL of the control group (P<0.05). Other peripheral blood B lymphocyte subsets (CD20+, CD40L+ and CD5+CD19+) and Th1-type cytokines (IFN-γ, TGF-β and TNF-α) were respectively (6.84 ± 0.45)％, (9.45±0.63)％, (5.72±0.46)％, (105.64±10.72) ng/L, (276.72±34.75) pg/mL, (1.63±0.24)ng/mL, which were sig-nificantly higher than (3.31±0.25)％, (5.25±0.37)％, (2.43±0.22)％, (80.25±6.34) ng/L, (169.89±20.34) pg/mL and (0.83± 0.13) ng/mL of control group (P<0.05). The above indexes also showed statistically significant difference between the patient groups with different Child-pugh classifications and the patient groups with or without splenomegaly (P<0.05). Conclusion The peripheral blood T, B lymphocyte subsets and Th1-type cytokines of patients with cirrhosis caused by hepatitis B show obviously abnormal expression state, and those indexes all have certain detection value for the Child-pugh classifications and splenomegaly of patients with cirrhosis caused by hepatitis B.