丙型肝炎病毒感染者外周血淋巴细胞亚群的变化及意义

李元元，金磊，赫兢等.丙型肝炎病毒感染者外周血淋巴细胞亚群的变化及意义[J].临床肝胆病杂志, 2013, 29(2).132-135

淋巴细胞亚群 肝炎,丙型,慢性 肝炎病毒属

李元元，金磊，赫兢，福军亮，张晖，周春保，张政，王福生

(解放军第三○二医院生物治疗研究中心,北京,100039)；

2013

132-135

知网,万方

目的 调查丙型肝炎患者外周血淋巴细胞亚群变化及影响因素.方法 利用流式细胞术检测241例丙型肝炎患者和117例健康人群外周血淋巴细胞亚群数值,通过回顾性分析,调查我国丙型肝炎人群淋巴细胞亚群变化及其相关的影响因素.结果 在健康人群中,CD3+ CD4+T细胞、CD3+ CD16+ CD56+ NKT细胞频率以及CD4/CD8比值与年龄呈显著正相关；而在慢性丙型肝炎人群中,CD3+ CD4+T细胞与年龄呈显著正相关,CD3-CD19+B细胞则与年龄呈显著负相关；在肝硬化人群中,只有CD3-CD16+CD56+ NK细胞频率与年龄呈显著正相关；在15 ～49岁的健康人及慢性肝炎人群中,女性CD3+ CD4+T细胞亚群频率高于男性,而在肝硬化患者中女性CD3-CD19+B细胞频率低于男性；同时,在HCV感染的不同阶段,CD3-CD16+ CD56+ NK细胞亚群频率均较正常人显著降低,而CD3+ CD8+T细胞频率则显著升高,在15岁以上人群,CD3-CD19+B细胞在健康人、慢性肝炎、肝硬化人群中呈持续升高的现象.结论 通过回顾性分析健康人群和HCV感染不同阶段人群淋巴细胞亚群的分布特点及其与HCV疾病进展、年龄、性别的关系,为临床科学评价丙型肝炎人群免疫状态提供重要的免疫指标. Abstract:Objective To analyze the peripheral blood lymphocyte subsets in hepatitis C virus(HC`)一infected patients and determine their clinical implications. Methods Peripheral blood samples were collected from 241 patients diagnosed with HCV infection and 117 healthy adu上t controls between 2001 and 2009. Flow cvtometrv was used to detect the percentages of lymphocyte subsets in each sample，m- eluding CD3+T cells，CD3十CD4+T cells，CD3十CD8+ T cells，CD3一CD19+B cells，CD3一CD16+CD56一natural killer(NK) cells. and CD3+CDI6+CD56+NKT cells，as well as the GD4/CD8 ratio. Significance of between group differences was assessed by the Mann- Whitney U test. Potential cox-relation of lymphocyte subset percentages with patient age was anah0zed by the Spearman’s rank correlation co- efficient. Results The percentages of peripheral blood lymphocyte subsets detected in the healthy controls served as the reference stand- arils. In the healthy controls，the frequencies of CD3十CD4十T cells and CD3十CD16+CD56+NK cells，and the CD4/CD8 ratio were posi- tivelv correlated with increasing age. In the HCV一infected patients with chronic hepatitis，the frequency of CD3十CD4+T cells was also positively correlated with increasing age，but the frequency of CD3一CD19+B cells was negatively correlated with age. In HCV一infected patients with liver cirrhosis, the frequency of CD3一CD16+CD56十1K cells but higher frequency of CD3十CD8十T cells. HCV一infected patients more than 15 years old and having both chronic hepatitis and liver cirrhosis showed elevated frequency of CD3一CD19十B cells compared to healthy controls. Conclusion The percentages of peripheral blood lympho- cyte subsets are influenced by disease progression in chronic hepatitis C patients;the differential profile may be helpful for evaluating the im- mune status of HGV一infected subjects in clinic.