慢性乙型肝炎患者外周血CD4＋CD25＋、CD8＋CD28＋淋巴细胞的变化及与病毒载量的关系

目的：研究慢性乙型肝炎患者外周血CD4＋CD25＋、CD8＋CD28＋淋巴细胞的表达变化及与病毒载量的关系。方法：利用流式细胞术检测50例慢性乙型肝炎患者外周血CD4＋CD25＋、CD8＋CD28＋淋巴细胞的表达率和绝对数,并与正常对照组30例进行比较;荧光定量PCR检测慢性乙型肝炎患者HBV核酸的载量,并与CD4＋CD25＋、CD8＋CD28＋淋巴细胞的表达进行相关分析。结果：慢性乙型肝炎患者的CD4＋CD25＋表达率和细胞数分别为（15.60±5.86）%和（0.34±0.13）×109/L,明显高于正常对照组（P〈0.01）;而CD4＋CD25-、CD8＋CD28＋为（21.13±5.32）%、（0.47±0.19）×109/L和（9.49±2.57）%、（0.21±0.07）×109/L,均低于正常对照组（均P〈0.01）;不同病毒载量的慢性乙型肝炎患者CD4＋CD25＋T细胞与病毒载量均呈正相关（r分别为0.552、0.588,P均〈0.01）,而CD8＋CD28＋T细胞与病毒载量均无相关性（r分别0.275、-0.092,P均〉0.05）。结论：慢性乙型肝炎患者细胞毒T细胞（CD8＋CD28＋）减少,免疫调节细胞的增加与慢性乙型肝炎患者病毒长期存在,病程迁延不愈有关。

Relationship Between the Changes of Expressions of Peripheral Blood CD4+ CD25+, CD8+ CD28+ and Viral Load in Patients with Chronic Hepatitis B

Objective To study the changes of peripheral blood CD4＋CD25＋ and CD8＋CD28＋ as related to the viral load in patients with chronic hepatitis B.Methods Peripheral blood CD4＋CD25＋ and CD8＋CD28＋ expression percentage and absolute count（with flow cytometry） as well as viral load（with FQ-PCR） were determined in 50 patients with chronic hepatitis B and 30 controls（flow cytometry only）.Results The CD4＋CD25＋ expression percentage（15.60±5.86%） and count（0.34±0.13×109/L） were significantly higher than those in the controls（P0.01）,while the CD4＋CD25＋,CD8＋CD28＋ experssion rate（21.13±5.32% and 9.49±2.57% respectively） and count（0.47±0.19×109/L and 0.21±0.07×109/L respectively） were signifc cantly lower than those in controls（all P0.01）.The CD4＋CD25＋ expression rate and absolute count were positively correlated with the viral load（r=0.500,P0.01）,but the CD8＋CD28＋ expression rate and absolute count were not correlated with the viral load（r=0.147,P0.05）.Conclusion There was decrease of cytotoxic T cells（CD8＋CD28＋） in patients with chronic hepatitis B,On the contrary,the presence of increase of regulatory T cells（CD4＋CD25＋） might be related to the persistence of the hepatitis with increased viral load.