自身免疫性肝病患者外周血淋巴细胞亚群的频率变化及临床意义

目的调查原发性胆汁性肝硬化(PBC)、自身免疫性肝炎(AIH)及AIH-PBC重叠综合征患者外周血淋巴细胞亚群频率变化及其临床意义。方法本中心2001年6月-2010年12月期间,对41例AIH-PBC、37例AIH和36例PBC患者,以及50例健康人群外周血进行淋巴细胞亚群频率检测。分析患者年龄、性别、肝功能、是否肝硬化及淋巴细胞亚群频率的变化。结果与健康组相比,AIH-PBC重叠综合征组、PBC组和AIH组的CD3+CD4+T细胞频率显著升高,而CD3-CD16+CD56+NK细胞频率显著降低;PBC组和AIH-PBC重叠综合征中CD4+/CD8+比值、CD3-CD19+B细胞频率偏高,CD3+CD8+%T细胞频率降低。在疾病发展的不同阶段,AIH-PBC重叠综合征组和PBC组中,肝硬化组CD3+%T细胞频率、CD3+CD8+%T细胞频率较非肝硬化组偏低。结论通过回顾性分析健康人群和AIH、PBC及AIH-PBC重叠综合征患者淋巴细胞亚群的分布特点及其与疾病进展的关系,为临床科学评价上述自身免疫性肝病人群的免疫状态提供重要的免疫指标。

Changes in frequencies of peripheral blood lymphocyte subsets and their clinical significance in patients with autoim-mune liver diseases

Objective To investigate the changes in frequencies of peripheral blood lymphocyte （PBL）subsets and their clinical significance in patients with primary biliary cirrhosis （PBC）,autoimmune hepatitis （AIH）,and AIH-PBC overlap syndrome.Methods Forty-one patients with AIH-PBC overlap syndrome,37 patients with AIH,36 patients with PBC,and 50 healthy persons were included in the retrospective study.The frequencies of PBL subsets were determined by flow cytometry.The changes in frequencies of PBL subsets and their clinical significance were investigated.Results Compared with the healthy control group,the AIH-PBC group,PBC group,and AIH group had a significantly increased frequency of CD3 ^＋CD4 ^＋T cells and a significantly decreased frequency of CD3 -CD16 ^＋CD56 ^＋NK cells;the PBC group and AIH-PBC group had significantly increased CD4 ^＋/CD8 ^＋ratio and frequency of CD3 -CD19 ^＋B cells and a significantly decreased frequency of CD3 ^＋CD8 ^＋T cells.During different stages of diseases,in the AIH-PBC group and PBC group,the frequencies of CD3 ^＋T cells and CD3 ^＋CD8 ^＋T cells were significantly lower in patients with liver cirrhosis than in those without liver cirrhosis.Conclusion The changes in frequencies of PBL subsets are related to the progression of autoimmune liver diseases,providing important immunological parameters for clinical evaluation of the immune status in patients with autoimmune liver diseases.