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目的探讨慢性丙型肝炎(CHC)患者外周血T细胞免疫功能与丙型肝炎病毒(HCV)复制及核心抗原(HCV-cAg)表达的关系。方法采用流式细胞术、荧光定量PCR和ELISA对63例健康体检者(对照组)和85例CHC患者(CHC组)的外周血T淋巴细胞亚群、血清HCV-RNA和HCV-cAg进行测定。结果 CHC组总T细胞、T4细胞、T8细胞、双阴性细胞(DNT)、双阳性细胞(DPT)水平依次为(67.37±10.43)%、(37.11±10.28)%、(21.63±8.87)%、(7.80±4.57)%、(0.20±0.29)%,T4/T8比值为(2.18±1.26)%,绝对水平依次为(0.70±0.44)×109/L、(0.37±0.22)×109/L、(0.22±0.17)×109/L、(0.08±0.06)×109/L和(0.19±0.68)×107/L;CHC患者T8细胞水平显著减少(P<0.01),致使T4/T8比值升高(P<0.05);CHC患者总T细胞、T4细胞、T8细胞和DNT的绝对值均显著减少(P<0.05);HCV-RNA和HCV-cAg阳性时,T4细胞和DNT水平显著升高(P<0.05)。结论 CHC患者HCV复制表达时,患者T细胞亚群存在明显异常,T细胞免疫功能低下或免疫耐受是CHC迁延难愈的重要原因。
Objective To investigate the relationship between T cell immune function and hepatitis C virus (HCV) replication and core antigen (HCV-cAg) expression in patients with chronic hepatitis C (CHC). Methods T-lymphocyte subsets, serum HCV-RNA and HCV-cAg in 63 healthy subjects (control group) and 85 CHC patients (CHC group) were determined by flow cytometry, real-time PCR and ELISA. . Results The levels of total T cells, T4 cells, T8 cells, double negative cells (DNT) and double positive cells (DPT) in CHC group were 67.37 ± 10.43%, 37.11 ± 10.28% and 21.63 ± 8.87% (0.70 ± 0.44) × 109 / L, (0.37 ± 0.22) × 109 / L, and the absolute levels were (7.80 ± 4.57)% and (0.20 ± 0.29)% and T4 / T8 were 2.18 ± 1.26% (0.22 ± 0.17) × 109 / L, (0.08 ± 0.06) × 109 / L and (0.19 ± 0.68) × 107 / L respectively. T8 cells in CHC patients significantly decreased (P <0.01) (P <0.05). The absolute values of total T cells, T4 cells, T8 cells and DNT in CHC patients were significantly decreased (P <0.05). The levels of T4 and DNT were significantly increased in HCV-RNA and HCV- P <0.05). Conclusions The expression of HCV replication in CHC patients with abnormal T cell subsets, T cell immune dysfunction or immune tolerance is an important cause of CHC refractory.