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[目的]探讨HBV相关慢加急性(亚急性)肝衰竭(HBV-ACLF)患者外周血T细胞亚群、NK细胞的变化趋势及其与预后的关系。[方法]选取HBV-ACLF患者46例,慢性乙型肝炎(CHB)患者40例,健康志愿者20例,采用流式细胞仪检测外周血CD3+、CD4+、CD8+T细胞及NK细胞计数,用SPSS 18.0软件对其进行统计学分析。[结果]HBV-ACLF组外周血CD3+、CD4+T细胞、NK细胞计数与慢性乙肝组、健康对照组比较,差异均有统计学意义(P<0.01);HBV-ACLF组外周血CD8+T细胞与健康对照组相比,差异有统计学意义(P<0.01)。HBVACLF患者死亡组中CD3+、CD4+、CD8+T细胞及NK细胞计数均低于存活组,2组CD3+、CD4+、CD8+T细胞比较差异有统计学意义(P<0.01)。[结论]HBV-ACLF患者存在T细胞亚群失衡和细胞免疫紊乱,提示细胞免疫参与了HBV-ACLF的发病和进展。
[Objective] To investigate the change trend of T cell subsets and NK cells in peripheral blood of patients with HBV-related acute and subacute hepatic failure (HBV-ACLF) and its relationship with prognosis. [Methods] 46 patients with HBV-ACLF, 40 patients with chronic hepatitis B (CHB) and 20 healthy volunteers were enrolled. The counts of CD3 +, CD4 +, CD8 + T cells and NK cells in peripheral blood were detected by flow cytometry SPSS 18.0 software for statistical analysis. [Results] The levels of CD3 +, CD4 + T cells and NK cells in peripheral blood of patients with HBV-ACLF were significantly lower than those of patients with chronic hepatitis B and healthy controls (P <0.01) Compared with the healthy control group, the difference was statistically significant (P <0.01). The counts of CD3 +, CD4 +, CD8 + T cells and NK cells in the death group of HBVACLF patients were lower than that of the survivors group. The difference of CD3 +, CD4 + and CD8 + T cells in two groups was statistically significant (P <0.01). [Conclusion] The imbalance of T cell subsets and cellular immune disorders exist in patients with HBV-ACLF, suggesting that cellular immunity is involved in the pathogenesis and progression of HBV-ACLF.