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目的明确慢性乙型重型肝炎(简称慢重肝)患者肝内浸润的淋巴细胞(LILs)及外周血中免疫活性细胞的频率,并对其进行对比分析,以明确它们的异同以及在慢重肝发病机理中的作用。方法通过毛玻璃研磨加自然沉降肝细胞的方法,对11例慢重肝接受肝移植患者的 LILs 进行提取、分离。通过流式细胞仪测定慢重肝患者 LILs 及外周血中免疫活性细胞的频率并行对比分析,同时与正常人 LILs 及外周血中免疫活性细胞的频率进行对比分析。结果 (1)慢重肝患者 LILs 中CD4~+T 淋巴细胞及 B 细胞的频率分别为17%±6%及3.0%±1.0%,明显低于外周血中各自的频率,分别为32%±8%及21.4%±12.2%(均 P<0.01),而 CD8~+T 淋巴细胞、NK 及 NKT 细胞的频率分别为38%±13%、34%±18%及10%±4%,明显高于外周血中各自的频率,分别为26%±6%、15%±9%及6%±4%(均 P<0.05);(2)与正常对照相比,LILs 中 CD3~+及 CD4~+T 淋巴细胞明显要高(P<0.05或 P<0.01),而 NK 细胞及 NKT 细胞要低些;(3)与正常对照相比,慢重肝患者 LILs 与外周血淋巴细胞之比,CD3~+、CD4~+、CD8~+T 淋巴细胞有更高的比值(CD4~+T 淋巴细胞 P<0.01),B细胞及 NKT 细胞有更低的比值(P<0.01或 P<0.05)。结论肝脏内大量免疫活性细胞的浸润,尤其是 CD4~+、CD8~+T 淋巴细胞、NK 细胞的大量浸润对于慢重肝的发病可能起重要的作用。
Objective To determine the frequency of intrahepatic infiltration of lymphocytes (LILs) and immune cells in peripheral blood in patients with chronic severe hepatitis B (HCH) and to compare their frequency with those of chronic severe hepatitis Role in the pathogenesis. METHODS: LILs from 11 patients with chronic liver transplantation who underwent liver transplantation were extracted and separated by ground glass grinding plus natural sedimentation of liver cells. The frequencies of LILs and peripheral blood immunocompetent cells in patients with chronic severe hepatitis were determined by flow cytometry and compared with the frequencies of LILs in normal people and the immunocompetent cells in peripheral blood. Results (1) The frequencies of CD4 ~ + T lymphocytes and B cells in LILs from patients with chronic severe hepatitis were 17% ± 6% and 3.0% ± 1.0%, respectively, which were significantly lower than those in peripheral blood, which were 32% ± 8% and 21.4% ± 12.2% (all P <0.01). The frequencies of CD8 + T lymphocytes, NK and NKT cells were 38% ± 13%, 34% ± 18% and 10% ± 4% (26% ± 6%, 15% ± 9% and 6% ± 4%, respectively) in peripheral blood (all P <0.05). (2) Compared with the normal control, CD3 + CD4 ~ + T lymphocytes were significantly higher (P <0.05 or P <0.01), while NK cells and NKT cells were lower; (3) Compared with the normal control, the ratio of LILs to peripheral blood lymphocytes , CD3 ~ +, CD4 ~ +, CD8 ~ + T lymphocytes were higher (P <0.01), B cells and NKT cells were lower (P <0.01 or P <0.05 ). Conclusion The infiltration of a large number of immunocompetent cells in the liver, especially CD4 ~ +, CD8 ~ + T lymphocytes and NK cells may play an important role in the pathogenesis of chronic severe hepatitis.