乙肝病毒感染后不同临床类型及HBV DNA载量与外周血T细胞亚群变化的相关性分析

发布时间：2018-04-17 21:26

  本文选题：肝炎 + 乙型　； 参考：《中国现代医学杂志》2015年17期

【摘要】：目的探讨乙肝病毒(HBV)感染后不同临床类型乙型肝炎患者及HBV DNA载量与外周血T细胞亚群的关系。方法选取确诊的共193例急性乙型肝炎、慢性乙型肝炎、慢性重型肝炎、亚急性重型肝炎、急性重型肝炎、乙肝肝硬化、乙肝肝癌、HBV携带者的外周血,流式细胞仪检测T细胞亚群,荧光定量PCR法检测HBV DNA水平。结果对照组CD3+、CD4+细胞百分率、CD4+/CD8+细胞比值明显高于各临床类型组,随病情加重CD3+、CD4+细胞百分率、CD4+/CD8+细胞比值下降明显,除急性乙型肝炎组和慢性肝炎组CD4+细胞百分率外与各组比较差异有统计学意义(P0.05及P0.01);对照组CD8+细胞百分率、CD4+/CD25+细胞比值明显低于各临床类型组,随病情加重CD8+细胞百分率、CD4+/CD25+细胞比值升高明显,各组比较差异有统计学意义(P0.05及P0.01)。低水平HBV DNA载量组(≤103 Copies/ml)CD3+、CD4+细胞百分率明显高于其他各病毒组,随病毒载量增加CD3+、CD4+细胞百分率逐渐减少,与各组比较差异有统计学意义(P0.05及P0.01);低水平HBV DNA载量组CD8+细胞百分率最低,随病毒载量增加CD8+细胞百分率升高明显,与各组比较差异有统计学意义(P0.05及P0.01);低水平HBV DNA载量组CD4+/CD8+及CD4+/CD25+细胞比值最高,其比值随病毒载量增加下降明显,低水平组CD4+/CD25+细胞比值与各组比较差异有统计学意义(P0.05及P0.01),低水平组CD4+/CD8+细胞比值与各组(103~105组除外)比较差异有统计学意义(P0.05及P0.01)。除乙肝肝硬化的CD4+细胞百分率外,同病种肝病的HBV DNA(+)组CD3+、CD4+、CD8+细胞百分率、CD4+/CD8+及CD4+/CD25+细胞比值与HBV DNA(-)组比较,差异有统计学意义(P0.05及P0.01)。结论细胞免疫功能紊乱是HBV感染后发病机制之一,高水平HBV DNA载量可能诱导和加重细胞免疫功能紊乱,CD4+/CD8+及CD4+/CD25+比值变化可为了解病情变化和指导治疗提供依据。
[Abstract]:Objective to investigate the relationship between HBV DNA load and T cell subsets in peripheral blood of patients with hepatitis B virus (HBV) infection.Methods Peripheral blood samples of 193 patients with acute hepatitis B, chronic hepatitis B, chronic severe hepatitis, subacute severe hepatitis, acute severe hepatitis, liver cirrhosis and liver cancer were selected.T cell subsets were detected by flow cytometry and HBV DNA levels were detected by fluorescence quantitative PCR.Results the percentage of CD4 / CD8 cells of CD3 in the control group was significantly higher than that of each clinical type group, and the percentage of CD4 / CD8 cells in CD3 group decreased significantly with the exacerbation of the disease.The percentage of CD4 cells in acute hepatitis B group and chronic hepatitis group was significantly higher than that in each group (P 0.05 and P 0.01), and the percentage of CD8 cell in control group was significantly lower than that in each clinical type group, and the ratio of CD4 / CD25 cells in control group was significantly lower than that in each clinical type group.The percentage of CD8 cells and the ratio of CD4 / CD25 cells increased significantly with the exacerbation of the disease, and the differences were statistically significant (P 0.05) and P 0.01 (P < 0.05).The percentage of CD4 cells in low level HBV DNA group (鈮，

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