摘要
目的探讨HBV感染者外周血肝功能主要指标、T细胞亚群以及病毒载量在不同病程中的变化及其临床意义。方法170例HBV感染患者根据病程分成急性乙肝组（18例）、慢性乙肝组（73例）、肝硬化组（41例）及肝癌组（38例），正常对照组40例。用全自动生化分析仪和流式细胞仪检测各组肝功能相关指标及T细胞亚群含量；采用实时荧光定量PCR法检测HBV．DNA含量。结果四组实验组与正常对照相比谷丙转氨酶（ALT）、谷草转氨酶（AST）均升高，差异具有统计学意义（P〈0．05），且以急性乙肝升高最为显著，慢性乙肝次之，组间比较可见慢性乙肝患者组比急性乙肝患者组A坍、AST有所下降，且差异具有统计学意义（P〈0．05），而肝癌患者组和肝硬化组之间则变化不显著，差异无统计学意义（P〉0．05）；碱性磷酸酶ALP的升高见于肝癌患者组，慢性乙肝患者组ALP水平较低；各组总蛋白（TP）均在正常参考范围内。四组实验组外周血CD3^＋T细胞均比正常对照组低，其中肝癌组、肝硬化患者组降低最为明显，CD4^＋T细胞比例上升见于急性乙肝组，而CD8^＋T细胞的比例在急性乙肝患者组中最低。外周血中HBV病毒核酸载量升高的最为明显的是慢性乙肝患者组，而急性乙肝患者组、肝硬化患者组、肝癌患者组的HBV—DNA水平比较低，以急性乙肝最低，各组与其相比均具有统计学差异（P〈0．05）。结论HBV不同病程中患者的肝功能相应指标、T细胞亚群表达、HBV-DNA含量存在显著差异，联合检测这些项目可为临床正确评估患者的病情及病程提供相应指导，为疾病转归的判断及治疗提供可靠的依据。
Objective To explore the changes of main indexes of liver function of peripheral blood, T cell subsets and the viral load in hepatitis B virus infection patients in different course and its clinical significance. Method 170 cases of hepatitis B virus infection patients were divided into acute hepatitis B group （ 18 cases）, chronic hepatitis B group （73 cases）, liver cirrhosis group （41 cases） ,hepatic carcinoma group （38 cases） , and normal control group of 40 cases according to the course. The related indexes of liver function and T cell subsets were detected by the automatic biochemical analyzer and flow eytometry, and the content of HBV- DNA was detected by real-time fluorescent quantitative PCR method. Results Alanine transaminase （ALT） and aspartate transaminase （AST） increased in four experimental groups compared to normal controls, with significant difference （ P 〈 0.05 ）, and the increase was most significant in acute hepatitis, chronic hepatitis B was the second. ALT and AST of chronic hepatitis B was decreased compared with acute hepatitis B, and the difference had statistical significance （ P 〈 0.05 ）, but the change between liver cancer and liver cirrhosis group was not significant, have no significant difference （P 〉0.05）. The increase of alkaline phosphatase（ALP） was in liver cancer patients, the levels of ALP in chronic hepatitis B was low. Groups of total protein （TP） were with- in the normal reference range. CD3 ^＋ T cells in peripheral blood of the four experimental groups were lower than in the normal controls, the patients with hepatic carcinoma and cirrhosis was obviously lower. The proportions ofCD4 ^＋ T cells rose in acute hepatitis group, but the percentage of CD8 ^＋ T cells is the lowest in acute hepatitis B patients. The most obvious rise of HBV DNA virus load in peripheral blood was in chronic hepatitis B group, but the HBV-DNA level is relatively low in acute hepatitis, liver cirrhosis and liver cancer patients, the lowest was in
出处
《国际免疫学杂志》
CAS
2015年第2期138-142,共5页
International Journal of Immunology
基金
项目资助：苏州市科学技术局资助（SYS201433
SYS201155）
江苏省卫生厅资助（KF200974）
