乙型肝炎患者外周血T淋巴细胞亚群变化及临床意义

目的 观察不同类型乙型肝炎病毒（hepatitis B virus,HBV）感染者外周血T淋巴细胞亚群变化特点.方法 对我院2013年6-11月门诊及住院的200例乙肝患者和50例健康对照者采用流式细胞术（flow cytometry,FCM）检测外周血淋巴细胞（CD45＋）、T淋巴细胞（CD45＋CD3＋、CD45＋CD3＋CD4＋、CD45＋CD3＋CD8＋）、B淋巴细胞（CD45＋CD3-CD19＋）、NK淋巴细胞（CD45＋CD3-CD16＋56＋）百分比和细胞绝对计数.结果 急性乙型肝炎组T淋巴细胞总数、CD4＋和CD8＋T淋巴细胞数较健康对照组显著升高（P＜0.01）.慢性乙型肝炎组、肝硬化组和肝衰竭组：T淋巴细胞总数、CD4＋和CD8＋T淋巴细胞数、CD4＋/CD8＋比值均较健康对照组降低,其中肝衰竭组＜肝硬化组＜慢性乙型肝炎组.慢性乙型肝炎组CD4＋淋巴细胞百分比较健康对照组显著降低（P＜0.01）.肝硬化组CD4＋淋巴细胞百分比较慢性乙型肝炎组显著降低（P＜0.01）,CD8＋T淋巴细胞百分比显著升高（P＜0.01）.肝衰竭组T淋巴细胞和CD4＋T淋巴细胞百分比较肝硬化组显著降低（P＜0.01）.结论 乙型肝炎患者CD4＋T淋巴细胞持续降低,与疾病病程发展密切相关.

T lymphocyte subsets in peripheral blood of hepatitis B patients and its clinical significance

Objective To observe the characteristics of T lymphocyte subsets in peripheral blood of hepatitis B patients. Methods Peripheral T-lymphocytes （CD45＋CD3＋, CD45＋CD3＋CD4＋, CD45＋CD3＋CD8＋）, B-lymphocytes （CD45＋CD3-CD19＋）, NK- lymphocytes （CD45＋CD3- CD16＋56＋） in 200 hepatitis B patients who visited our outpatient department in our hospital from June 2013 to November 2013 and in 50 healthy controls were detected by flow cytomentry. Results The total number of T lymphocytes and the number of CD4＋ and CD8＋T were significantly higher in acute hepatitis B patients than in healthy controls （P 〈 0.01）. The total number of T lymphocytes, the number of CD4＋ and CD8＋ T lymphocytes and the CD4＋/CD8＋ T lymphocytes ratio were significantly lower in chronic hepatitis B patients, cirrhotic patients and liver failure patients than in healthy controls （P 〈 0.01）. The percentage of CD4＋ lymphocytes was significantly lower in chronic hepatitis B patients than in healthy controls and in cirrhotic patients than in chronic hepatitis B patients while the CD8＋ T lymphocytes ratio was significantly higher in cirrhotic patients than in chronic hepatitis B patients and the T lymphocytes and CD4＋ T lymphocytes ratio was significantly lower in liver failure patients than in cirrhotic patients （P 〈 0.01）. Conclusion The number of CD4＋T lymphocytes and cellular immune function decrease in hepatitis B patients, thus inducing persistent HBV infection. Peripheral T lymphocyte subsets are closely related with the progress of disease.