不同免疫状态慢性HBV感染患者的T淋巴细胞及NKG2D表达差异研究

目的探讨慢性HBV感染者在不同免疫状态下的T淋巴细胞及自然杀伤细胞G2D(NKG2D)表达差异。方法根据免疫状态的不同将80例慢性HBV感染患者分为免疫耐受组(28例)、免疫清除组(30例)、低(非)复制组(22例),另选取30名健康体检者作为对照组。对4组研究对象进行外周血T淋巴细胞亚群、NK细胞、NKG2D细胞频率及血清肿瘤坏死因子-α(TNF-α)、γ干扰素水平检测。结果4组研究对象的CD3^+T淋巴细胞百分比,差异均无统计学意义(P>0.05)。免疫清除组的CD4^+T淋巴细胞、CD4^+/CD8^+、NK细胞百分比分别为(30.14±5.36)%、(1.10±0.33)%、(9.67±4.31)%,均显著低于另外三组,CD8^+T淋巴细胞、NKG2D+/NK细胞百分比分别为(33.56±5.37)%、(12.96±3.42)%,均显著高于另外三组(P<0.05)。免疫耐受组和低(非)复制组的NKG2D^+/NK细胞百分比分别为(3.46±1.15)%和(3.55±1.07)%均显著低于对照组,免疫清除组的NKG2D+/NK细胞百分比显著高于对照组(P<0.05)。免疫清除组的TNF-α、γ干扰素水平分别为(69.62±16.46)ng/L和(69.85±12.30)ng/L,均显著高于免疫耐受组、低(非)复制组及对照组(P<0.05)。免疫耐受组、低(非)复制组及对照组的TNF-α、γ干扰素水平比较,差异均无统计学意义(P>0.05)。结论慢性HBV感染患者在不同免疫状态下,外周血淋巴细胞及NKG2D细胞表达有明显差异,临床可通过测定HBV感染者外周血T淋巴细胞、NKG2D细胞水平来评估患者的免疫状态,指导临床治疗。

Differential expression of T lymphocyte and NK G2D in patients with chronic HBV infection in different immune states

Objective To investigate the difference of T lymphocyte and natural killer cell G2D(NKG2D)expression in chronic HBV infected persons under different immune conditions.Methods Eighty patients with chronic HBV infection were divided into immune tolerance group(28 cases),immune clearance group(30 cases)and low(non)replication group(22 cases)according to the different immune status.Another 30 healthy people were selected as control group.Peripheral blood T lymphocyte subsets,NK cells,NKG2D cell frequencies and serum levels of tumor necrosis factor-alpha(TNF-α)and interferon-γwere measured among four groups.Results The percentage of CD3^+T cells in the four groups was not statistically significant(P>0.05).The percentage of CD4^+,CD4^+/CD8^+,NK cells in the immune clearance group were(30.14±5.36)%,(1.10±0.33)%,(9.67±4.31)%,which were significantly lower than the other three groups.The percentage of CD8^+,NKG2D^+/NK cells were(33.56±5.37)%,(12.96±3.42)%,which were significantly higher than the other three groups(P<0.05).The percentage of NKG2D^+/NK cells in immune tolerance group and low(non)replication group were(3.46±1.15)%and(3.55±1.07)%respectively,which were significantly lower than that in control group,and the percentage of NKG2D+/NK cells in immune clearance group was significantly higher than that in control group(P<0.05).The levels of TNF-αand IFN-γin immune clearance group were(69.62±16.46)ng/L and(69.85±12.30)ng/L respectively,which were significantly higher than those in immune tolerance group,low(non)replication group and control group(P<0.05).There was no significant difference in the levels of TNF-αand IFN-γbetween the immune tolerance group,the low(non)replication group and the control group(P>0.05).Conclusion The expression of peripheral blood lymphocyte and NKG2D cells in patients with chronic HBV infection is significantly different under different immune conditions.The immune status of patients can be evaluated by measuring the levels of peripheral blood T lymphocyte and NKG2D cells in patients with HBV infection to guide clinical treatment.