摘要
目的了解四川地区不同疾病谱慢性HBV感染者的基因型分布情况,研究不同基因型与细胞免疫及凝血功能的关系。方法选取2015年1月-2017年6月于成都市公共卫生临床医疗中心住院的四川地区慢性HBV感染者543例,其中包括慢性HBV携带者31例、慢性乙型肝炎285例、重症乙型肝炎77例、乙型肝炎肝硬化81例以及肝细胞癌69例。收集患者血液标本,采用基因芯片法检测HBV DNA基因型,检测T淋巴细胞亚群,同时进行凝血功能测定计量资料多组间比较采用方差分析,进一步两两比较采用SNK-q检验;计数资料多组间比较采用χ2检验。结果543例慢性HBV感染者中B型400例,占73.66%,C型123例,占22.65%,B、C混合型及C、D混合型各10例,各占1.84%。B型与C型相比,不同疾病谱中HBV基因型的分布、凝血酶原时间及凝血酶原活动度比较,差异均无统计学意义(P值均>0.05)。T淋巴细胞亚群测定结果显示,各疾病谱内CD3+、CD3+CD4+数量在重症乙型肝炎组,CD3+CD8+数量在慢性乙型肝炎组,CD4+/CD8+在慢性HBV携带者组、重症乙型肝炎组及乙型肝炎肝硬化组C型均高于B型;而乙型肝炎肝硬化组中CD3+、CD3+CD4+数量、CD3+CD8+数量和肝细胞癌组中CD3+、CD3+CD4+数量、CD3+CD8+数量、CD4+/CD8+则是C型均低于B型,其中乙型肝炎肝硬化患者CD3+CD4+(t=2.078,P=0.041)、CD3+CD8+(t=6.672,P<0.001)数量比较差异有统计学意义,其余指标组内比较均无统计学差异(P值均>0.05)。结论四川地区不同疾病谱慢性HBV感染者基因分型以B型、C型常见,B型为主,各疾病谱中HBV基因型的分布无差异。在慢性HBV感染者体内存在细胞免疫功能的紊乱,且在感染的不同阶段,机体的免疫紊乱各不相同,感染不同的基因型与凝血功能及细胞免疫功能的变化无明显相关。
Objective To investigate the genotype distribution of chronic hepatitis B virus(HBV)infection patients with different disease spectrums in Sichuan,China,as well as the association of genotypes with cellular immunity and coagulation function.Methods A total of 543 patients with chronic HBV infection who were hospitalized in Chengdu Public Health Medical Center from January 2015 to June 2017 were enrolled,among whom there were 31 chronic HBV carriers,285 patients with chronic hepatitis B(CHB),77 patients with severe hepatitis B,81 patients with hepatitis B cirrhosis,and 69 patients with hepatocellular carcinoma(HCC).Blood samples were collected;gene microarray was used to determine the genotypes of HBV DNA,and T lymphocyte subsets and coagulation function were measured.An analysis of variance was used for comparison of continuous data between multiple groups,and the SNK-q test was used for further comparison between two groups;the chi-square test was used for comparison of categorical data between groups.Results Among the 543 patients with chronic HBV infection,400(73.66%)had type B infection,123(22.65%)had type C infection,10(1.84%)had mixed type B and C infection,and 10(1.84%)had mixed type C and D infection.There were no significant differences in the distribution of HBV genotypes,prothrombin time,and prothrombin activity in different disease spectrums between the patients with type B infection and those with type C infection(all P>0.05).According to the results of T lymphocyte subsets,in the severe hepatitis B group,the patients with type C infection had higher percentages of CD3+and CD3+CD4+T cells than those with type B infection;in the chronic hepatitis B group,the patients with type C infection had a higher percentage of CD3+CD8+T cells than those with type B infection;in the chronic HBV carrier group,severe hepatitis B group,and hepatitis B cirrhosis group,the patients with type C infection had a higher CD4+/CD8+ratio than those with type B infection;in the hepatitis B cirrhosis group,the patients with typ
作者
李守娟
王丽
陈竹
胡朝霞
王磊
吴蓓
朱丽
段萌
LI Shoujuan;WANG Li;CHEN Zhu(Department of Hepatology, Chengdu Public Health Medical Center, Chengdu 610066, China)
出处
《临床肝胆病杂志》
CAS
北大核心
2020年第5期1014-1018,共5页
Journal of Clinical Hepatology
基金
成都市卫生和计划生育委员会(2015101)。
关键词
乙型肝炎病毒
基因型
免疫
细胞
血液凝固
四川
hepatitis B virus
genotype
immunity,cellular
blood coagulation
Sichuan
