摘要
目的探讨 Th1/Th2、Tcl/Tc2亚群比例在慢性 HBV 感染的临床分型中的变化,以及在慢性 HBV 感染免疫病理损伤中的作用。方法用 PMA、Ionomycin 作为刺激剂,采用流式细胞仪(FACS)胞内细胞因子法对慢性 HBV 感染者外周血CD3^+CD8^+T 细胞和 CD3^+CD8^-T 细胞内 IFN-γ和 IL-4的表达进行分析,比较慢性肝炎、肝炎肝硬化(活动性)、慢性重症肝炎各组 Th1/Th2、Tc1/Tc2亚群比例变化。结果慢性肝炎、肝炎肝硬化(活动性)、慢性重症肝炎患者的 Th1、Tc1细胞均高于正常对照组。慢性重症肝炎组 Th1、Tc1显著高于慢性肝炎、正常对照组(P<0.01),慢性重症肝炎组 Tcl 显著高于活动性肝炎后肝硬化组(P<0.05)。肝炎肝硬化(活动性)组 Tcl 显著高于正常对照组(P<0.05)。Th1、Tc1细胞随着慢性乙型肝炎肝脏炎症活动的加剧而增高。而 Th2、Tc2细胞则在各组中均无显著性差异(P>0.05)。慢性重症肝炎患者恢复期 Th1和 Tc1细胞显著低于治疗前水平(P<0.01)。结论在慢性 HBV 感染中,机体免疫平衡偏向 Th1类反应,Th1、Tc1细胞与肝脏炎症活动严重程度呈正相关。提示 Th1和 Tc1细胞在慢性乙型肝炎肝脏病理发生中可能起了重要作用。
t Objective To investigate the changes in Thl/rh2 and Tcl/Tc2 balance and its role in immuno-pathological damage in patients with chronic HBV infection. Methods After stimulation using phorboe-12-myristate-13-asetate （PMA）/Ionomycin/ Monensin, the levels of expression of IL-4 and IFN-γ in CD3＋CD8＋ T cells and CD3＋CD8- T cells were determined with fluorescence activated cell sorting （FACS） in peripheral blood samples from the patients with chronic HBV infection. Meanwhile, the changes in Th1/ Th2 and Tc1/Tc2 balance were compared among the patients with chronic hepatitis B, active liver cirrhosis or chronic severe hepatitis. Results The percentages of Thl and Th2 cells were significantly higher in the patients with chronic hepatitis B, active liver cirrhosis or chronic severe hepatitis than those in the controls. The percentages of Thl and Tc1 cells were markedly higher in the patients with chronic severe hepatitis than in those with chronic hepatitis B and controls （P〈0.01）. The percentage of Tcl cells was remarkably higher in the patients with chronic severe hepatitis than in those with active liver cirrhosis （P〈0.05）. The percentage of Tcl cells in the patients with active liver cirrhosis was significantly higher than that in normal controls （P〈0.05）. The increased percentages of Th1 and Tc1 cells were positively correlated with the severity of hepatic inflammation. There were no significant differences in percentages of Th2 and Tc2 cells among different groups （P〉0.05）. The percentages of Th1 and Tc1 cells in recovery phase was markedly lower than that before treatment in patients with chronic severe hepatitis （P〈0.01）. Conclusions Cellular immunity is shifted to Thl type immunity in the patients with chronic HBV infection. Meanwhile, the Th1 and Tc1 cytokines are positively correlated to hepatic inflammatory activity in the patients. Thl and Tcl cells may play an important role in pathogenesis of chronic hepatitis B.
出处
《传染病信息》
2005年第4期173-176,共4页
Infectious Disease Information
