重型乙型病毒性肝炎肝组织内T淋巴细胞亚群的观察

本文用抗CD_3,CD_4,CD_8McAb和ABC法检测21例重型乙肝患者肝大片,亚大片坏死区炎性浸润细胞中的T细胞亚群,CD_3~+细胞>70％,其中主要为CD_8~+细胞,CD_4~+细胞减少,CD_4~+/CD_8~+比值显著下降,与急黄肝和慢活肝比较差异显著。相反,非HBV感染性肝病患者非T细胞和CD_4~+细胞增加,CD_4~+/CD_8~+比值>1。提示重肝时T细胞可能参与了肝损伤,CD_8细胞亚群可能是介导肝细胞坏死的重要因素之一。还观察到相当数量的淋巴细胞和肝细胞HLA—DR抗原阳性,淋巴细胞与膜型HBAg(+)肝细胞密切接触。

Observation of T Lymphocyte Subsets in Liver Tissues of Severe B-viral Hepatitis

T lymphocyte subsets in the infiltrating cells in the areas of massive or submassive necrosis of patients(n=21)with severe B-viral hepatitis were investigated using monoclonal antibodies(McAb)against human T lymphocyte surface antigen--CD3,CD4, CD8 by avidin-biotin-peroxidase complex technique(ABC). More than 70% of infiltrating cell type were CD3+cells(total T lymphocytes), in which the majority were the CD8+(suppressor /cytotoxic)cells. CD4+(inducer/holper)cells were decreased and CD4+/CD8+ ratios were reduced markedly. In comparision with acute icteric hepatitis B(n=11)and chronic active hepatitis B(n=28),the CD8+ cells in patients with severe hepatitis B were markedly hig-her and CD4+/CD8+ ratios markedly lower. By contrast, inpatients with liver diseases (n=5) without HBV infection, the number of non-T and CD4+ cells were increased, CD4+/CD8+ ratios were more than 1. These data suggested that T lymphocytes might play an important role in the mechanism leading to tissue injury. The subpopulation, CD8+ cells may be one of the important immunological factors resulted in destruction of hepatocytes.A fair number of HLA-DR (Human Leucocyte Antigen-DR) positive lymphocytes and hepatocytes and close apposition between infiltrating lymphocytes and membranous HBAg( + ) hepatocytes could be observed.