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目的观察HBV病毒水平和淋巴细胞亚群变化在肝纤维化进程中的价值。方法采用荧光定量PCR、流式细胞术及放射免疫法(RIA)方法检测100例慢性乙型肝炎患者淋巴细胞亚群和肝纤维化指标,同期选取健康对照组并进行统计学处理。结果与健康对照组相比,DNA阴性组淋巴细胞分型的差异无统计学意义,但肝纤指标则明显增加(PCⅢ:118.43±17.83 vs 79.43±6.08;Ⅳ-C:98.26±10.23vs48.66±6.26;LN:112.48±13.63vs87.04±6.73;HA:98.28±15.68vs33.00±6.66;P均<0.05);低病毒载量组与DNA阴性组相比,CD8+T细胞增多(36.18±6.88vs28.13±5.11,P<0.05),高病毒载量组与DNA阴性组相比,CD4+T细胞显著减少(33.54±4.99vs38.38±5.81,P<0.05)、CD8+T细胞明显增多(38.15±7.92vs28.13±5.11,P<0.05)、CD4+/CD8+下降(1.06±0.41vs1.42±0.39,P<0.05),但肝纤四项均明显增高(P<0.05)。结论慢性HBV感染患者在疾病进展中选择合适的时机联合检测,将为早期干预和抗病毒治疗提供科学依据。
Objective To investigate the value of HBV virus and lymphocyte subsets in the process of liver fibrosis. Methods Fluorescent quantitative PCR, flow cytometry and radioimmunoassay (RIA) were used to detect lymphocyte subsets and hepatic fibrosis in 100 patients with chronic hepatitis B. The healthy controls were selected and statistically analyzed. Results Compared with healthy control group, there was no significant difference in DNA negative lymphocyte grouping, but the liver fibrosis index was significantly increased (PCⅢ: 118.43 ± 17.83 vs 79.43 ± 6.08; Ⅳ-C: 98.26 ± 10.23vs48.66 ± 6.26; LN: 112.48 ± 13.63vs87.04 ± 6.73; HA: 98.28 ± 15.68vs33.00 ± 6.66; P <0.05 respectively); CD8 + T cells increased in low viral load group compared with DNA negative group ± 6.88vs28.13 ± 5.11, P <0.05). CD4 + T cells were significantly decreased in high viral load group compared with DNA negative group (33.54 ± 4.99vs38.38 ± 5.81, P <0.05) (P <0.05), CD4 + / CD8 + decreased (1.06 ± 0.41vs1.42 ± 0.39, P <0.05), but the four items of liver fibrosis were significantly increased (P <0.05). Conclusion Chronic HBV infection in patients with disease progression in the selection of the appropriate timing of joint testing, early intervention and antiviral therapy will provide a scientific basis.