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目的:比较慢性乙型肝炎(CHB)感染者外周血T细胞亚群的变化,探讨其与临床疾病状态的关系。方法:用流式细胞术(FCM)检测HBeAg阳性ALT异常者42例(A组);HBeAg阳性ALT持续正常者25例(B组);HBsAg阳性、HBeAg、HBV-DNA及ALT正常者20例(C组);健康体检(各型病毒学指标均为阴性)者25例外周血中T淋巴细胞亚群。结果:A、B组CD4+T细胞数量较C组及正常组明显降低;而CD8+T细胞数量较正常组明显升高(P<0.01),CD4+/CD8+、CD4+CD25+T细胞与正常组比较明显降低(P<0.05)。结论:慢性乙肝HBeAg阳性ALT正常患者Ts细胞数量增多,Th细胞和CTL细胞受到抑制,乙肝病毒复制与CD4+T细胞及CTL数量低下,抑制性T细胞增高高度相关。通过T淋巴细胞亚群的检测可以监控患者的免疫状态,从而为指导临床免疫治疗提供依据。
Objective: To compare the changes of peripheral blood T lymphocyte subsets in patients with chronic hepatitis B (CHB) infection and to explore their relationship with clinical disease status. Methods: Forty-two patients with abnormal HBeAg-positive ALT were detected by FCM (group A), 25 patients with normal HBeAg-positive ALT (group B), 20 patients with positive HBsAg, HBeAg, HBV DNA and normal ALT (C group). Twenty-five T lymphocyte subsets in peripheral blood were detected in healthy subjects (all virological indicators were negative). Results: The numbers of CD4 + T cells in group A and group B were significantly lower than those in group C and normal, while the number of CD8 + T cells in group A and group B were significantly higher than those in normal group (P <0.01). The numbers of CD4 + / CD8 +, CD4 + Group was significantly lower (P <0.05). Conclusion: The number of Ts cells in patients with chronic hepatitis B HBeAg-positive ALT is increased, and the number of Th cells and CTL cells is inhibited. The replication of hepatitis B virus is highly correlated with the low numbers of CD4 + T cells and CTLs and the increase of inhibitory T cells. T lymphocyte subsets through the detection of patients can monitor the immune status, which provide guidance for clinical immunotherapy.