摘要
目的探讨慢性丙型肝炎患者外周血CTLA-4的变化规律及其临床意义。方法纳入55例慢性丙型肝炎患者和41例健康对照者，分离外周血单个核细胞，应用ⅣI’-PCR法检测CTLA-4mRNA相对表达水平；采用荧光定量RT．PCR检测HCVRNA。结果慢性丙型肝炎患者外周CTLA-4mRNA水平是健康对照组的3．47倍，差异有统计学意义（P〈0．05）。HCV1b基因型患者CTLA-4mRNA水平较2a基因型分别升高3．8l倍，差异有统计学意义（P〈0．05）。丙氨酸氨基转移酶（ATJT）〉3ULN组和天门冬氨酸氨基转移酶（AST）〉3ULN组患者CTLA．4mRNA水平分别显著低于ALT〈3ULN和AST〈3ULN组（P：0．026〈0．05）。结论HCV感染者机体处于一定的免疫耐受状态，HCV1b基因型的患者机体处于较强的免疫耐受状态，T细胞反应性较低。CTLA4表达水平降低可以启动炎症反应并加重慢性丙肝者肝细胞损伤。CTLA-4可能在HCV感染慢性化中发挥重要作用。
Objective To investigate the changes and clinical significance of peripheral blood CTLA-4 in patients with chronic hepatitis C. Methods Fifty-five patients with chronic hepatitis C and 41 healthy control were enrolled in this study. Peripheral blood monouelear cells （PBMC）were isolated. The related mRNA expressions of CTLA-4 were measured by RT-PCR;HCV RNA was detected by real- time RT-PCR. Results The level of CTLA-4 mRNA increased in chronic hepatitis C, with 3.47-time higher than those in healthy controls. The expression of CTLA-4 mRNA significantly increased in HCV genotype lb than those in HCV genotype 2a,with 3.81-time higher（P 〈 0. 05）. The levels of CTLA-4 mRNA increased in patients with ALT and AST more than 3 upper normal levels （ P = 0.026 〈 0.05 ）. Conclusions HCV infection result in immunologic tolerance, which is more severe in HCV genotype 1 b. It is possible that the decrease expression of CTLA-4 gene would start inflammatory response and fa- vour persistent hepatocellular lesion in chronic hepatitis C. CTLA-4 may take part in the immune toler- ance induced by the HCV infection and play an important role in chronic HCV infection.
出处
《中国实用医刊》
2013年第22期28-30,共3页
Chinese Journal of Practical Medicine
