乙型肝炎病毒感染者外周血T细胞亚群和穿孔素-颗粒酶变化

目的探讨HBV感染者外周血单个核细胞（PBMC）中T淋巴细胞亚群分布频率及穿孔素和颗粒酶B表达的变化。方法通过细胞表面标记和细胞内细胞因子染色技术．采用流式细胞术分析HBV感染者PBMC中CD4^＋、CD8^＋T细胞的分布以及穿孔素和颗粒酶B的表达。结果与正常对照相比，急性和慢性乙肝患者CD4^＋T细胞百分率无明显改变，CD8^＋T细胞以及穿孔素和颗粒酶B表达均显著增高（前者P〈0．01，后者P〈0．05）。HBV携带者CD4^＋T细胞显著降低（P〈0．05），CD8^＋T无明显改变。三组CD4^＋／CD8^＋T比例均显著降低（P〈0．05）。结论与HBV携带者不同，急性和慢性乙肝患者CD8可细胞频数及穿孔素和颗粒酶B表达均明显增高，提示细胞毒T细胞的数量及细胞毒颗粒表达与病毒清除和肝损害相关；急性和慢性患者在增高程度上的差异提示慢性乙肝的细胞免疫和细胞毒反应的不完全。

Variations of Peripheral Blood T Lymphocyte Subsets and Perforin-Granzyme B in the Patients with Hepatitis B Virus Infection

Objective To investigate the frequency of peripheral blood T lymphocyte subsets and perforin-granzyme B in the patients with hepatitis B virus infection. Methods The fi＇equency of T-lymphocyte subsets （CD4^＋T, CD8^＋T） and perforin-granzyme B in peripheral blood mononuclear cell （PBMC） were determined by flow cytometry analysis with cell surface markers and intracellular staining technology. Results Compared with control group, the patients with acute and chronic hapetiti B （CHB） exhibited significant increases in frequency of CD8^＋T and perforin-granzyme B expression （P〈0.01 and P〈0.05）, but there was a extent difference between two HBV infection groups. And the HBV carriers exhibited significant decrease in frequency of CD4^＋T cell （P〈0.05）, no changes in CD8^＋T cell and per form -granzyme B expression. The ratio ofCD4 vs CD8 in three HBV infection groups are all decreased （P〈0.05）. Conclusion The increases in frequency of cytotoxic T lymphocyte （CTL） and cytotoxic granules expression contribute to viral clearance and liver cell injury during HBV infection. The extent difference in frequency of CTL and cytotoxic granules expression between acute and chronic HBV infection may suggest a cellular immune defect in CHB patients.