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目的探讨慢性HBV感染者疾病不同阶段外周血淋巴细胞亚群及免疫球蛋白IgG和补体C3、C4的变化特点。方法将80例慢性HBV感染者及20例健康体检查作为研究对象,根据病情将80例慢性HBV感染者分为慢乙肝组,肝硬化组,慢加急性肝衰竭组,健康体检者为对照组。采用流式细胞术检测所有研究对象的外周血T淋巴细胞亚群及CD3-CD19~+细胞(B细胞),采用免疫散射法测定血清IgG和补体C3、C4含量;并进行组间比较分析。结果对照组、慢乙肝组、肝硬化组、慢加急性肝衰竭组患者外周血CD3~+T细胞、CD4~+T细胞、CD8~+T细胞百分比顺序递减,B细胞百分比顺序上升,慢乙肝组、肝硬化组及慢加急性肝衰竭组患者CD3~+T细胞百分比均显著低于较对照组,B细胞百分比均高于对照组,组间比较差异有统计学意义(P<0.05)。对照组、慢乙肝组、肝硬化组及慢加急性肝衰竭组血清IgG顺序升高,补体(C3、C4)含量顺序下降,组间比较差异有统计学意义(P<0.05)。结论慢性HBV感染者体内存在淋巴细胞亚群失衡和细胞免疫功能紊乱,体液免疫也发生明显改变,外周血淋巴细胞亚群及血清IgG和补体检测对于了解患者免疫状态,判断病情发展阶段以及预测预后有一定临床应用价值。
Objective To investigate the changes of peripheral blood lymphocyte subsets, immunoglobulin IgG, complement C3 and C4 in patients with chronic HBV infection at different stages. Methods Eighty patients with chronic HBV infection and 20 healthy people were enrolled in this study. Eighty patients with chronic HBV infection were divided into chronic hepatitis B group, cirrhosis group, acute hepatic failure group and healthy control group according to their condition . The peripheral blood T lymphocyte subsets and CD3-CD19 ~ + cells (B cells) were detected by flow cytometry in all the subjects. The contents of IgG and complement C3 and C4 were measured by immunostaining method and compared among groups. Results The percentages of CD3 ~ + T cells, CD4 ~ + T cells and CD8 ~ + T cells in the control group, chronic hepatitis B group, cirrhosis group and chronic hepatic failure group decreased gradually, the percentage of B cells increased sequentially, The percentage of CD3 ~ + T cells in patients with cirrhosis, chronic cirrhosis and chronic liver failure group were significantly lower than those in control group, and the percentages of B cells in control group were significantly higher than those in control group (P <0.05). Serum IgG in control group, chronic hepatitis B group, cirrhosis group and chronic and acute liver failure group were increased, and the contents of complement (C3 and C4) were decreased in sequence. There was significant difference between the two groups (P <0.05). Conclusion There is imbalance of lymphocyte subsets and cellular immune dysfunction in chronic HBV infected persons. The humoral immunity also changes obviously. The detection of peripheral blood lymphocyte subsets, serum IgG and complement may be helpful to understand the immune status of patients, determine the stage of disease progression and prognosis There is a certain clinical value.