慢性丙型肝炎患者外周血T淋巴细胞亚群和ALT、AST与其血清HCV-RNA的相关性分析

发布时间：2018-05-03 17:39

本文选题：CHC + PCR　；参考：《安徽医科大学》2014年硕士论文

【摘要】：目的本研究旨在探讨人体外周静脉血中T淋巴细胞亚群和谷丙转氨酶(ALT)、谷草转氨酶(AST)与慢性丙型肝炎(Chronic hepatitis C、CHC)患者丙型肝炎病毒(HCV)核糖核酸(RNA)复制程度的关系。方法搜集安徽医科大学第一附属医院传染病科2012年5月~2013年2月连续10个月内门诊及住院的CHC成年患者169例,同期120例正常健康者的EDTA-K2抗凝外周静脉血1 ml和非抗凝外周静脉血4 ml。采用流式细胞仪直接免疫荧光法对所搜集的病人外周抗凝静脉血中的T细胞亚群进行检测;利用荧光定量PCR法检测成年患者及正常健康者的非抗凝血分离的血清中的丙型肝炎病毒核糖核酸(HCV RNA)的复制浓度。采用OLYMPUS640生化分析仪检测ALT、AST的浓度结果①CHC患者CD4+T细胞百分率(42.87±6.11)及CD4+/CD8+比值(1.34±0.25)明显低于正常健康者(49.55±6.68)和(1.82±0.11)(P0.01),而CD8+T细胞百分率(32.78±5.48)则高于正常健康者(27.35±4.32)(P0.01),CD3+T细胞百分率无差异(P0.05)。②荧光定量PCR法检测CHC患者的结果为载量大于1.00×105 copies/ml,57例;载量在1.00×103~1.00×105 copies/ml,55例;载量小于1.00×103 copies/ml,57例;120例正常健康者载量均在0~1.0×103。通过检测结果的统计学分析得知随着HCV RNA复制载量的增加,CD8+T细胞百分率逐渐增加,而CD4+T细胞百分率及CD4+/CD8+比值逐渐降低。③载量大于1.00×103 copies/ml 112例标本中有77例ALT异常,异常率68.7%,同时有70例AST异常,异常率62.5%,统计学分析ALT、AST异常随着HCV-RNA含量的增加而升高,二者呈正相关系(r=0.871,P0.05)而ALT、AST浓度变化与HCV-RNA含量无相关性(r=0.031,P0.05)结论外周T淋巴细胞亚群比例改变,可能是HCV感染慢性化的重要原因之一。随着HCV RNA表达水平的升高,可能是导致T淋巴细胞应答能力下降的重要原因。ALT、AST只是反应肝脏病理变化的炎症指标。
[Abstract]:Objective to investigate the relationship between T lymphocyte subsets in human peripheral venous blood and the degree of replication of hepatitis C virus (HCV) ribonucleic acid (RNAs) in patients with chronic hepatitis C (chronic hepatitis C) by alanine aminotransferase (alt) and alanine aminotransferase (alt). Methods 169 outpatients and inpatients with CHC from May 2012 to February 2013 in Department of Infectious Diseases, first affiliated Hospital of Anhui Medical University were collected. At the same time, 1 ml of EDTA-K2 anticoagulant peripheral venous blood and 4 ml of non-anticoagulant peripheral venous blood were obtained from 120 healthy subjects. The T cell subsets in peripheral anticoagulant venous blood were detected by flow cytometry. The replication concentration of hepatitis C virus ribonucleic acid (HCV) RNA in sera from adult patients and healthy controls was detected by fluorescence quantitative PCR. The percentage of CD4 T cells and CD4 / CD8 ratio in 1CHC patients were significantly lower than those in normal controls (49.55 卤6.68) and 1.82 卤0.11 (P 0.01), while the percentage of CD8 T cells (32.78 卤5.48) was higher than that of normal controls (27.35 卤4.32). The results of fluorescence quantitative PCR assay for the detection of CHC were as follows: the carrying capacity was more than 1.00 脳 10 ~ 5 copias / ml ~ (-1) in 57 cases. The loading capacity was 1.00 脳 10 ~ 3 / L 1.00 脳 10 ~ 5 copias / ml ~ (-1) and less than 1.00 脳 10 ~ (3) / ml ~ (-1) / ml ~ (-1) in 120 normal controls. The loading capacity was 1.0 脳 10 ~ (3) / 10 ~ (-1). With the increase of HCV RNA replication load, the percentage of CD8 T cells increased, while the percentage of CD4 T cells and the ratio of CD4 / CD8 decreased gradually. There were 77 cases of ALT abnormality in the 112 samples with CD4 / CD8 ratio > 1.00 脳 10 ~ 3 copies/ml. The abnormal rate of AST was 68.7%, and there were 70 cases of abnormal AST, the abnormal rate was 62.5%. Statistical analysis showed that the abnormality of alt increased with the increase of HCV-RNA content, and there was a positive correlation between the changes of alt AST concentration and the content of HCV-RNA. Conclusion the ratio of peripheral T lymphocyte subsets was changed, and there was no correlation between the changes of alt AST concentration and HCV-RNA content. It may be one of the important causes of chronic HCV infection. With the increase of HCV RNA expression level, it may be an important reason that T lymphocyte response ability decreases. Alt AST is only an inflammatory index reflecting the pathological changes of liver.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R512.63

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