乙型肝炎儿童T细胞亚群与病毒复制及病毒载量关系的研究
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摘要
目的探讨乙型肝炎患儿T细胞亚群与病毒复制及病毒载量的关系。方法选取乙型肝炎病毒脱氧核糖核酸(hepatitis B virus-desoxyribose nucleic acid,HBV-DNA)阳性的慢性乙型肝炎患儿58例为研究对象,其中乙型肝炎E抗原(human hepatitis B virus e antigen,HBeAg)阳性41例、HBeAg阴性17例,低载量患儿24例、中载量患儿19例、高载量患儿15例;另选取同期健康体检儿童35例为对照组。采用荧光定量PCR法检测HBVDNA,应用流式细胞仪测定CD3+、CD4+、CD8+,计算CD4+/CD8+。结果慢性乙型肝炎患儿CD3+、CD4+、CD4+/CD8+低于对照组,CD8+高于对照组(P<0.01)。中载量组CD3+、CD4+、CD4+/CD8+低于低载量组,高载量组CD3+、CD4+、CD4+/CD8+低于低载量组和中载量组(P<0.01);中载量组和高载量组CD8+高于低载量组(P<0.01)。HBeAg阳性患儿CD3+、CD4+、CD4+/CD8+均低于HBeAg阴性患儿,CD8+高于HBeAg阴性患儿(P<0.01)。结论乙型肝炎患儿T细胞亚群的改变不仅与HBV感染有关,而且还与HBV-DNA复制有关,其复制可进一步加重细胞免疫功能紊乱。
Objective To explore the correlation of T lymphocytes with virus replication and viral load in children with hepatitis B.Methods Fifty-eight children with chronic hepatitis B,who were positive for hepatitis B virus-desoxyribose nucleic acid(HBV-DNA),were selected as the research subjects.Among them,41 had positive human hepatitis B virus e antigen(HBeAg),17 had negative HBeAg,24 had low viral load,19 had moderate viral load,and 15 had high viral load.Moreover,35 healthy children were served as the control group.FQ-PCR was used to detect HBV-DNA.FCM was used to detect CD3~+ ,CD4~+ ,and CD8~+ .CD4~+ /CD8~+ were calculated.Results CD3~+ ,CD4~+ ,CD4~+ /CD8~+ in children with Chronic hepatitis B were lower than the control group,CD8~+ was higher than the control group(P<0.01).CD3~+ ,CD4~+ ,CD4~+ /CD8~+ in load group were lower than that of low load group,CD3~+ ,CD4~+ ,CD4~+ /CD8~+ in higher load group were lower than that of low load group and load group(P<0.01),load group and high load of CD8~+ was higher than that of low load group(P<0.01).The CD3~+ ,CD4~+ and CD4~+ /CD8~+ of HBeAg positive children were lower than those of HBeAg negative children,and CD8~+ was higher than that of HBeAg negative children(P<0.01).ConclusionChanges of T lymphocyte subsets in children with hepatitis B was not only associated with HBV infection,but also correlated with the replication of HBV-DNA,which can further aggravate the cellular immune dysfunction.
Objective To explore the correlation of T lymphocytes with virus replication and viral load in children with hepatitis B.Methods Fifty-eight children with chronic hepatitis B,who were positive for hepatitis B virus-desoxyribose nucleic acid(HBV-DNA),were selected as the research subjects.Among them,41 had positive human hepatitis B virus e antigen(HBeAg),17 had negative HBeAg,24 had low viral load,19 had moderate viral load,and 15 had high viral load.Moreover,35 healthy children were served as the control group.FQ-PCR was used to detect HBV-DNA.FCM was used to detect CD3~+ ,CD4~+ ,and CD8~+ .CD4~+ /CD8~+ were calculated.Results CD3~+ ,CD4~+ ,CD4~+ /CD8~+ in children with Chronic hepatitis B were lower than the control group,CD8~+ was higher than the control group(P<0.01).CD3~+ ,CD4~+ ,CD4~+ /CD8~+ in load group were lower than that of low load group,CD3~+ ,CD4~+ ,CD4~+ /CD8~+ in higher load group were lower than that of low load group and load group(P<0.01),load group and high load of CD8~+ was higher than that of low load group(P<0.01).The CD3~+ ,CD4~+ and CD4~+ /CD8~+ of HBeAg positive children were lower than those of HBeAg negative children,and CD8~+ was higher than that of HBeAg negative children(P<0.01).ConclusionChanges of T lymphocyte subsets in children with hepatitis B was not only associated with HBV infection,but also correlated with the replication of HBV-DNA,which can further aggravate the cellular immune dysfunction.
引文
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[4]高章圈,李国正,赵建宏,等.河北省开展国家孕前优生健康检查项目临床检验室室间质评结果分析[J].河北医科大学学报,2017,38(2):196-200.
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[8]润袁敏,饶绘,裴姣,等.乙型肝炎病毒感染患者发病中CD8+T细胞的临床作用机制研究[J].中华医院感染学杂志,2016,26(16):3625-3627.
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[10]李冶刚,张超飞,郭希邦.慢性乙型肝炎病毒感染者外周血淋巴细胞亚群的变化及检测意义[J].中国慢性病预防与控制,2015,23(10):775-776.
[11]朱文静,陈江,逯心敏,等.乙型肝炎病毒感染相关疾病患者T淋巴细胞亚群的变化与意义[J].国际检验医学杂志,2015,36(8):1102-1103.
[12]林建军,赵冬久,童美琴,等.解毒化瘀疏肝方对慢性乙型病毒性肝炎外周血T淋巴细胞亚群的影响[J].中华中医药学刊,2015,33(7):1747-1749.
[13]聂红明,汪蓉,朱梅萍,等.不同临床状态的HBV感染相关肝病患者T淋巴细胞水平和主要细胞因子表达的比较[J].中西医结合肝病杂志,2015,25(1):8-12.
[14]邵锦帆,袁晓东,骆必伟,等.慢性乙型肝炎患者外周血中记忆T细胞亚群分布研究[J].江苏预防医学,2015,26(3):15-17.
[15]程萍,薛博瑜.HBV感染相关性肝病中调节性T淋巴细胞和辅助性T淋巴细胞17失衡的研究进展[J].临床肝胆病杂志,2015,31(4):603-606.
[16]陈健青,李国英,章旭平,等.巨细胞病毒感染致肝炎患儿外周血T淋巴细胞的表达和意义[J].中国妇幼保健,2015,30(15):6020-6022.
[17]杜振华,鲍布和,王仁杰,等.外周血DNT细胞及T细胞亚群变化与乙型肝炎慢性化的相关性研究[J].检验医学,2015,30(7):723-727.
[18]蒙达礼,苏明华,江建宁,等.慢性乙肝病毒携带者血清ALT、AST、HBV-DNA及HBVM与肝组织病理的关系[J].广西医科大学学报,2015,32(2):229-231.
[19]闰泰山,刘杰.儿童慢性乙型肝炎病毒携带者T细胞亚群与病毒载量的关系[J].中国药物经济学,2014,9(11):237-238,239.
[20]郭银燕,袁春蓓,俞海英,等.慢性乙型肝炎与肝衰竭患儿外周血T淋巴细胞亚群的差异[J].肝脏,2014,19(7):515-517.
[21]李铃,敬雪明,朱其荣,等.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[J].中国现代医学杂志,2015,25(17):35-41.
[22]王慰,杨莉,高恒波,等.不同血清HBV DNA载量慢性乙型肝炎病毒携带者外周血T淋巴亚群的变化[J].实用肝脏病杂志,2015,18(1):74-75.
[23]刘玲.慢性乙肝患者HBV-DNA载量与免疫学检测及肝功能的关系分析[J/CD].临床医药文献电子杂志,2016,3(34):6773.
[24]郑长涛,李东良,吴志贤,等.替比夫定联合阿德福韦酯治疗青年高病毒载量HBeAg阳性慢性乙型肝炎的临床观察[J].药物评价研究,2016,39(4):619-622.
[25]夏红,周智,杨玉霞.乙型肝炎患者恩替卡韦抗病毒治疗后外周血T淋巴细胞PD-1的表达及其与HBeAg血清学的关系[J].海南医学院学报,2016,22(7):655-657.
[26]马骉,陈恋恋,朱春凯,等.慢性乙型肝炎患者血清HBV-DNA与e抗原含量的关系[J].中国现代药物应用,2016,10(8):28-29.
[27]刘斯静,高霞,薛鹏,等.PNPLA3基因多态性与HBV感染易感性的关联性分析[J].河北医科大学学报,2017,38(6):628-632.
[2]曾跃红,田海清,王新华,等.乙型病毒性肝炎临床转归与机体细胞免疫功能状况的相关性研究[J].中国医药导报,2015,12(5):8-11,12.
[3]王晓宁,贺鹏程,郭彩利,等.HBV感染对淋巴瘤患者自体外周血造血干细胞采集及植入的影响[J].中国实验血液学杂志,2016,24(5):1397-1403.
[4]高章圈,李国正,赵建宏,等.河北省开展国家孕前优生健康检查项目临床检验室室间质评结果分析[J].河北医科大学学报,2017,38(2):196-200.
[5]王京晶.观察HBeAg阳性慢性乙型肝炎患者细胞免疫功能对抗病毒疗效的影响[J].吉林医学,2015,36(9):1832.
[6]中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2010年版)[J].中华肝脏病杂志,2011,19(1):13-24.
[7]杨新星,李东升,周继光,等.乙肝病毒感染不同阶段抗原肽特异性细胞毒性T淋巴细胞的初步研究[J].中国免疫学杂志,2016,32(10):1496-1502.
[8]润袁敏,饶绘,裴姣,等.乙型肝炎病毒感染患者发病中CD8+T细胞的临床作用机制研究[J].中华医院感染学杂志,2016,26(16):3625-3627.
[9]陈旭,陈洁,胡娅莉,等.乙型肝炎病毒母婴传播及其预防的研究进展[J].现代妇产科进展,2014,23(10):844-846,848.
[10]李冶刚,张超飞,郭希邦.慢性乙型肝炎病毒感染者外周血淋巴细胞亚群的变化及检测意义[J].中国慢性病预防与控制,2015,23(10):775-776.
[11]朱文静,陈江,逯心敏,等.乙型肝炎病毒感染相关疾病患者T淋巴细胞亚群的变化与意义[J].国际检验医学杂志,2015,36(8):1102-1103.
[12]林建军,赵冬久,童美琴,等.解毒化瘀疏肝方对慢性乙型病毒性肝炎外周血T淋巴细胞亚群的影响[J].中华中医药学刊,2015,33(7):1747-1749.
[13]聂红明,汪蓉,朱梅萍,等.不同临床状态的HBV感染相关肝病患者T淋巴细胞水平和主要细胞因子表达的比较[J].中西医结合肝病杂志,2015,25(1):8-12.
[14]邵锦帆,袁晓东,骆必伟,等.慢性乙型肝炎患者外周血中记忆T细胞亚群分布研究[J].江苏预防医学,2015,26(3):15-17.
[15]程萍,薛博瑜.HBV感染相关性肝病中调节性T淋巴细胞和辅助性T淋巴细胞17失衡的研究进展[J].临床肝胆病杂志,2015,31(4):603-606.
[16]陈健青,李国英,章旭平,等.巨细胞病毒感染致肝炎患儿外周血T淋巴细胞的表达和意义[J].中国妇幼保健,2015,30(15):6020-6022.
[17]杜振华,鲍布和,王仁杰,等.外周血DNT细胞及T细胞亚群变化与乙型肝炎慢性化的相关性研究[J].检验医学,2015,30(7):723-727.
[18]蒙达礼,苏明华,江建宁,等.慢性乙肝病毒携带者血清ALT、AST、HBV-DNA及HBVM与肝组织病理的关系[J].广西医科大学学报,2015,32(2):229-231.
[19]闰泰山,刘杰.儿童慢性乙型肝炎病毒携带者T细胞亚群与病毒载量的关系[J].中国药物经济学,2014,9(11):237-238,239.
[20]郭银燕,袁春蓓,俞海英,等.慢性乙型肝炎与肝衰竭患儿外周血T淋巴细胞亚群的差异[J].肝脏,2014,19(7):515-517.
[21]李铃,敬雪明,朱其荣,等.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[J].中国现代医学杂志,2015,25(17):35-41.
[22]王慰,杨莉,高恒波,等.不同血清HBV DNA载量慢性乙型肝炎病毒携带者外周血T淋巴亚群的变化[J].实用肝脏病杂志,2015,18(1):74-75.
[23]刘玲.慢性乙肝患者HBV-DNA载量与免疫学检测及肝功能的关系分析[J/CD].临床医药文献电子杂志,2016,3(34):6773.
[24]郑长涛,李东良,吴志贤,等.替比夫定联合阿德福韦酯治疗青年高病毒载量HBeAg阳性慢性乙型肝炎的临床观察[J].药物评价研究,2016,39(4):619-622.
[25]夏红,周智,杨玉霞.乙型肝炎患者恩替卡韦抗病毒治疗后外周血T淋巴细胞PD-1的表达及其与HBeAg血清学的关系[J].海南医学院学报,2016,22(7):655-657.
[26]马骉,陈恋恋,朱春凯,等.慢性乙型肝炎患者血清HBV-DNA与e抗原含量的关系[J].中国现代药物应用,2016,10(8):28-29.
[27]刘斯静,高霞,薛鹏,等.PNPLA3基因多态性与HBV感染易感性的关联性分析[J].河北医科大学学报,2017,38(6):628-632.