乙型肝炎肝硬变患者淋巴细胞亚群的特点及其与细菌感染的关系

目的：分析乙肝病毒引起的肝炎肝硬变患者外周血淋巴细胞亚群的比例和细胞绝对数的特点，并分析其与发生机会性感染的关系。方法：选择乙肝病毒引起的肝炎肝硬变患者74例，其中发生院内细菌感染者24例，未发生感染者50例，20例健康人为对照组。对健康人和两组病人的外周血白细胞数、淋巴细胞亚群(包括CD4^ 、CD8^ T细胞、NK细胞、B细胞)比例和绝对数特点及临床意义进行研究。结果：肝炎肝硬变患者较正常人CD8^ T细胞比例下降，致CD4／CD8比值升高，同时有B细胞比例和绝对数的上升；CD8^ T细胞和NK细胞绝对数下降。患者中发生细菌感染组CD4^ T细胞绝对数、CD8^ T细胞绝对数均较未发生感染组低。结论：乙肝病毒引起的肝炎肝硬化患者淋巴细胞亚群的变化，主要表现为CD8^ T细胞比例和绝对数下降，B细胞比例和绝对数上升和NK细胞数的下降。患者中CD4^ T细胞数和CD8^ T细胞数低者更容易发生细菌感染。

Change of peripheral lymphocyte subsets and its relationship with bacterial infections in liver cirrhotic patients with chronic hepatitis B virus infection

Objective:To investigate the change of peripheral lymphocyte subsets in liver cirrhotic patients with chronic hepatitis B virus (HBV) infection. Methods:Seventy-four patients with liver cirrhosis were included in our research and 20 healthy people were used as controls. Blood routine tests and lymphocyte subsets including CD4 + T cells,CD8 + T cells,B cells and NK cells were detected in all subjects. Results:The ratio of CD8 + T cells dropped but ratio of B cells rose in patients than that in controls. The numbers of CD8 + T cells and NK cells were lower but B cells were higher in patients than that in controls. The numbers of CD8 + T cells and CD4 + T cells were lower in infected group than that in uninfected group. Conclusions:The ratio and number of peripheral lymphocyte subsets in liver cirrhotic patients with HBV infection were significantly different from those in healthy people. Among the changes lower ratio and number of CD8 + T cells and higher ratio and number of B cells were significant .The liver cirrhotic patients who have lower absolute counts of CD4 + and CD8 + T cells were more susceptible to bacterial infections.