重型肝炎患者淋巴细胞亚群的变化及其意义

为了解重型肝炎(SH)患者T淋巴细胞亚群的变化及对疾病的预后的影响。对我院收治的46例重型肝炎病例(死亡组29例,存活组17例)与40例慢乙肝(CHB)的抗凝血,通过流式细胞仪检测其T淋巴细胞亚群,并与临床预后进行比较。结果:SH T淋巴细胞亚群计数CD3 、CD4 CD8-、CD4-CD8 细胞明显低于CHB组(P<0.05),可检测到大量幼稚的CD4 CD8 双阳细胞且其计数明显高于慢乙肝组(P<0.001),SH死亡组CD3 细胞明显低于存活组(P=0.04),CD4 CD8 双阳细胞明显高于存活组(P=0.005)。存活组随着病程恢复,CD3 、CD4 CD8-、CD4-CD8 细胞缓慢上升,死亡组持续低水平;存活组病程恢复时CD4 CD8 细胞逐渐下降,但死亡组反而上升。结论:T淋巴细胞亚群的变化特别是CD4 CD8 细胞的上升对预后判断有重要参考价值。

The changes and significance of T - lymphocytes subsets in severe hepatitis patients

To study the changing of whole blood T-lymphocytes subsets in severe hepatitis patients and its effect on the prognosis.46 patients severe hepatitis of(including 17 dead cases and 29 surviving cases who had been hospitalized from July,2002 to December,2004) and 40 chronic hepatitis B patients' T-lymphocytes subsets were detected by flow cytometry.From the changes of T lymphocytes subsets we compared their related clinical prognosis of each case.Results: The average CD3~ ,CD4~ CD8~-,CD4~-CD8~ lymphocytes counts in severe hepatitis group were lower than chronic hepatitis controls groups There could be detected a lot of puerile CD4~ CD8~ lymphocytes in severe hepatitis group,whose counts were higher than chronic hepatitis group,The counts of CD3~ lymphocyte in severe hepatitis dead group were lowe than recover group,The count of CD4~ CD8~ lymphocytes in death groups were higher than that of recover groups.(P=0.005).The CD3~ ,CD4~ CD8~ ,CD4~-CD8~ lymphocytes was gradually increasing in severe hepatitis surviving group with the progress of clinical recovering while remained in low level in dead group for long.The CD4~ CD8~ lymphocytes was gradually deceasing in severe hepatitis surviving group with the progress of clinical recovering while was increasing in severe hepatitis dead group.Conclusion: The changes of T-lymphocytes subsets especially the elevation of counts of CD4~ CD8~ lymphocytes may be one important marker to predict the clinical prognosis.