乙肝病毒感染者淋巴细胞亚群失衡与细胞免疫功能紊乱的临床研究

目的 研究不同临床类型乙型肝炎病毒（HBV）感染淋巴细胞亚群变化情况,探讨HBV感染与细胞免疫紊乱关系.方法 以364例HBV感染患者作为研究对象,41例健康体检人员作为对照,比较急性肝炎组（78例）、慢性肝炎组（244例）、肝硬化组（42例）淋巴细胞亚群变化及不同HBV DNA载量HBV感染患者淋巴细胞亚群变化.结果 慢性肝炎组、肝硬化组CD3＋、CD4＋、CD8＋均明显降低,其中肝硬化组下降较为显著,组间差异有统计学意义（P＜0.05）,慢性肝炎组CD4 ＋/CD8＋明显降低与对照组和急性肝炎组差异均有统计学意义（P＜0.05）,急性肝炎组CD8＋明显高于对照组,差异有统计学意义（P＜0.05）,慢性肝炎组、肝硬化组CD3、CD4＋、CD8＋与急性肝炎组、对照组比较差异有统计学意义（P＜0.05）;HBV-DNA高载量组与低载量组淋巴细胞亚群比较,CD8＋较高,CD4＋/CD8＋较低,差异有统计学意义（P＜0.05）.结论 慢性肝炎及肝硬化均存在一定程度的细胞免疫功能低下,对患者淋巴细胞亚群的监测及患者免疫功能评估有重要的临床应用价值.

Clinical study of imbalance of lymphocyte subsets and cellular immune dysfunction in hepatitis B virus infection patients

Objective To study the changes of lymphocyte subsets in different clinical types of hepatitis B virus （HBV） infection,and to investigate the relationship between cellular immune dysfunction and HBV infection.Methods 364 cases of HBV infection patients were as the research objects,41 cases of healthy persons were as controls.The changes of lymphocytes subsets in acute hepatitis group （78 cases）,chronic hepatitis group （244 cases）,liver cirrhosis group （42 cases） were compared,and the changes of lymphocyte subsets in different HBV DNA loads in HBV infection patients were compared.Results CD3 ＋,CD4 ＋,CD8 ＋ in chronic hepatitis group,liver cirrhosis group were significantly decreased,especially those in the cirrhosis group decreased more significantly,there was significant difference between two groups （P ＜ 0.05）.CD4 ＋/CD8 ＋ was significantly decreased in chronic hepatitis group compared with acute hepatitis group and control group （P ＜ 0.05）,CD8 ＋ was higher in acute hepatitis group than that in the control group （P ＜ 0.05）.There were significant difference in CD3 ＋,CD4 ＋,CD8 ＋ in chronic hepatitis group,liver cirrhosis group compared with acute hepatitis group and control group （P ＜ 0.05）.Compared with low HBV DNA loads group,CD8 ＋was higher and CD4 ＋/CD8 ＋ ratio was lower in high HBV DNA loads group （P ＜ 0.05）.Conclusion Chronic hepatitis and liver cirrhosis have a certain degree of cellular immunity,and it has important clinical application value for monitoring subsets of lymphocytes and evaluation on immune function.