慢性乙型肝炎患者在不同肝功能情况下外周血中的T淋巴细胞亚群、补体C3、补体C4及HBV-DNA的比较
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摘要
目的比较慢性乙型肝炎(CHB)患者在不同肝功能情况下外周血中T淋巴细胞亚群,补体C3、C4与HBV-DNA。方法选取136例CHB患者,根据治疗前后肝功能变化情况将患者分为好转组和恶化组。检测2组患者外周血中T淋巴细胞亚群,补体C3、C4和HBV-DNA。结果好转组72例,恶化组64例,恶化组患者与好转组患者CD3+比较,差异无统计学意义(P>0.05)。恶化组患者与好转组患者比较,CD4+明显减少,而CD8+明显增加,同时CD4+/CD8+比值明显下降,差异均有统计学意义(P<0.05)。恶化组患者补体C3、C4水平相较于好转组均有不同程度的下降,差异均有统计学意义(t=12.124、P=0.003,t=4.041、P=0.010)。好转组患者和恶化组患者HBV-DNA比较,差异无统计学意义(t=-2.598、P=0.793)。结论相比于补体C4、T细胞亚群和HBV-DNA,补体C3水平更能反映CHB患者肝功能损伤的情况。
Objective To compare the T-lymphocyte subpopulations,complement C3,C4 and HBV-DNA in the peripheral blood of patients with chronic hepatitis B under different liver function.Methods A total of 136 patients with chronic hepatitis B were selected,the patients were divided into improved group and deteriorated group according to the changes of hepatic function.T-lymphocyte subpopulations,complement C3,complement C4 and HBV-DNA in two groups were determined.Results A total of 72 patients were included in improved group,64 patients were included in deteriorated group.CD4+in deteriorated group was significantly decreased,and CD8+was significantly increased compared with those in improved group(P<0.05),CD3+had no statistical difference between the two groups(P>0.05).Complement C3 and complement C4 in deteriorated group decreased compared with those in the improved group(t=12.124,P=0.003;t=4.041,P=0.010).However,HBV-DNA had no statistical difference between two groups(t=-2.598,P=0.793).Conclusion Compared with T-lymphocyte subpopulations,complement C4 and HBV-DNA,complement C3 has a better sensitivity to reflect the damage of the hepatic function in patients with chronic hepatitis B.
Objective To compare the T-lymphocyte subpopulations,complement C3,C4 and HBV-DNA in the peripheral blood of patients with chronic hepatitis B under different liver function.Methods A total of 136 patients with chronic hepatitis B were selected,the patients were divided into improved group and deteriorated group according to the changes of hepatic function.T-lymphocyte subpopulations,complement C3,complement C4 and HBV-DNA in two groups were determined.Results A total of 72 patients were included in improved group,64 patients were included in deteriorated group.CD4+in deteriorated group was significantly decreased,and CD8+was significantly increased compared with those in improved group(P<0.05),CD3+had no statistical difference between the two groups(P>0.05).Complement C3 and complement C4 in deteriorated group decreased compared with those in the improved group(t=12.124,P=0.003;t=4.041,P=0.010).However,HBV-DNA had no statistical difference between two groups(t=-2.598,P=0.793).Conclusion Compared with T-lymphocyte subpopulations,complement C4 and HBV-DNA,complement C3 has a better sensitivity to reflect the damage of the hepatic function in patients with chronic hepatitis B.
引文
[1]谢晶日,李婷婷,李明,等.慢性乙型病毒性肝炎免疫耐受的研究进展[J].中华中医药学刊,2014,32(1):12-14.
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[10]陈轶,陈益耀,韩向阳,等.乙型肝炎病毒感染患者外周血T细胞亚群的表达特征与相关性研究[J].中华医院感染学杂志,2016,26(5):979-981.
[11]林孟新,苏智军,郭如意.乙型肝炎患者血清免疫球蛋白和补体C3/C4检测的意义[J].实用肝脏病杂志,2015,18(2):182-183.
[12]吕邦泰,高国生,冯家飞,等.慢性乙型肝炎患者血清补体C3和C4检测的临床意义再探讨[J].中国卫生检验杂志,2012,22(6):1327-1328.
[13]邱国华,高媛娇,申戈,等.肝病患者血清补体C3检测的临床意义[J/CD].中华实验和临床感染病杂志(电子版),2012,6(2):32-35.
[14]刘兴晖,周新,宋惠,等.乙型肝炎病毒在体内外抑制补体C3和C4表达的研究[J].中华微生物学和免疫学杂志,2011,31(10):927-930.
[15]张继承,鲁晓擘,张跃新.核苷类似物治疗慢性重型乙型肝炎后CD4+CD25+调节性T细胞表达下降[J].肝脏,2010,15(1):5-7.
[16]王平忠,张中伟,周永兴,等.定量PCR检测慢性乙型肝炎患者HBV-DNA及其意义[J].世界华人消化杂志,2000,8(7):755-758.
[2]纪翠霞,胡九东,邢练军,等.乙型肝炎慢性化机制的研究现状[J].临床肝胆病杂志,2012,28(2):149-152.
[3]黄河玉,方峰.补体在适应性免疫中的调节作用[J].中国免疫学杂志,2016,32(4):600-604.
[4]滕惠琴,张盛杰,齐艳艳,等.慢性乙型肝炎病毒感染者T淋巴细胞亚群的变化[J].肝脏,2012,17(2):108-109.
[5]中华医学会肝病学分会.慢性乙型肝炎防治指南2010年更新版[J/CD].中华实验和临床感染病杂志(电子版),2011,5(1):50-60.
[6]熊颖,房志刚,胡云毅,等.慢性乙型肝炎免疫治疗的研究[J].公共卫生与预防医学,2012,23(3):65-67.
[7]于晓辉,赵夏平,王维,等.乙型肝炎肝硬化患者外周血T淋巴细胞亚群和NK细胞的变化及临床意义[J].肝脏,2014,19(4):254-256.
[8]叶蔚,王小奇,叶彬.不同程度肝硬化患者血T细胞亚群及补体系统检测的意义[J].浙江临床医学,2005,7(1):73-74.
[9]杨晋辉,李祥金.乙型病毒性肝炎患者血清补体C3、补体C4的临床意义[J].临床肝胆病杂志,2007,23(5):355-356.
[10]陈轶,陈益耀,韩向阳,等.乙型肝炎病毒感染患者外周血T细胞亚群的表达特征与相关性研究[J].中华医院感染学杂志,2016,26(5):979-981.
[11]林孟新,苏智军,郭如意.乙型肝炎患者血清免疫球蛋白和补体C3/C4检测的意义[J].实用肝脏病杂志,2015,18(2):182-183.
[12]吕邦泰,高国生,冯家飞,等.慢性乙型肝炎患者血清补体C3和C4检测的临床意义再探讨[J].中国卫生检验杂志,2012,22(6):1327-1328.
[13]邱国华,高媛娇,申戈,等.肝病患者血清补体C3检测的临床意义[J/CD].中华实验和临床感染病杂志(电子版),2012,6(2):32-35.
[14]刘兴晖,周新,宋惠,等.乙型肝炎病毒在体内外抑制补体C3和C4表达的研究[J].中华微生物学和免疫学杂志,2011,31(10):927-930.
[15]张继承,鲁晓擘,张跃新.核苷类似物治疗慢性重型乙型肝炎后CD4+CD25+调节性T细胞表达下降[J].肝脏,2010,15(1):5-7.
[16]王平忠,张中伟,周永兴,等.定量PCR检测慢性乙型肝炎患者HBV-DNA及其意义[J].世界华人消化杂志,2000,8(7):755-758.