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目的 探讨慢性乙型肝炎患者外周血CD8淋巴细胞亚型与其临床状态及HBV复制的关系。方法 采用流式细胞技术多色荧光分析法,检测了18名健康体检者和107例慢性乙型肝炎患者外周血CD8淋巴细胞CD45R0、CD45RA和CD28的表达及病毒载量检测。结果 慢性病毒携带、慢性活动性肝炎患者CD8淋巴细胞与正常对照比较均无明显差别。慢性活动性肝炎组CD3+CD8+/CD45RO+淋巴细胞百分率为(15.7±3.35)％,明显高于正常对照(P<0.05),其CD3+CD8+/CD45RA+淋巴细胞百分率为(12.3±4.39)％,明显低于正常对照(p<0.05)。慢性活动性肝炎组CD3+CD8+CD28+细胞百分率为(23.7±3.35)％,明显高于正常对照(P<0.05),而慢性病毒携带组CD3+CD8+CD28-细胞百分率为(16.3±4.37)％,明显高于正常对照(P<0.05)。高病毒载量与低病毒载量患者的CD3+CD8+/CD45RO+亚型、CD3+CD8+/CD45RA+亚型均无明显差别,CD3+CD8+CD28+亚型和CD3+CD8+CD28-亚型亦无明显差别。结论 慢性乙型肝炎患者病情的进展与CD8淋巴细胞总量无关;可能是由于机体免疫功能增强,CD3+CD8+CD45RO+亚型、CD3+CD8+CD28+亚型淋巴细胞数升高,诱发细胞毒性淋巴细胞(CTL)作用的结果。但血清中病毒载量的变化与外周血中CD8淋巴细胞亚型无明显相关性。
Objective To investigate the relationship between CD8 lymphocyte subsets and clinical status and HBV replication in patients with chronic hepatitis B Methods The expression of CD45R0, CD45RA and CD28 in CD8 lymphocytes from 18 healthy volunteers and 107 patients with chronic hepatitis B were detected by flow cytometry and colorimetric assay. Results There was no significant difference in CD8 lymphocytes between patients with chronic viral infection and those with chronic active hepatitis compared with the control. The percentage of CD3 + CD8 + / CD45RO + lymphocytes in chronic active hepatitis group was (15.7 ± 3.35)%, which was significantly higher than that in control group (P <0.05). The percentage of CD3 + CD8 + / CD45RA + lymphocytes was (12.3 ± 4.39)% Lower than the normal control (p <0.05). The percentage of CD3 + CD8 + CD28 + cells in chronic active hepatitis group was (23.7 ± 3.35)%, which was significantly higher than that in control group (P <0.05), while the percentage of CD3 + CD8 + CD28- cells in chronic active hepatitis group was (16.3 ± 4.37) %, Significantly higher than the normal control (P <0.05). There were no significant differences in CD3 + CD8 + / CD45RO + subtypes and CD3 + CD8 + / CD45RA + subtypes between patients with high viral load and low viral load, with no significant difference between CD3 + CD8 + CD28 + and CD3 + CD8 + CD28- subtypes difference. Conclusion The progression of the disease in patients with chronic hepatitis B has nothing to do with the total amount of CD8 lymphocytes; it may be due to the enhancement of immune function, the increase of lymphocyte count of CD3 + CD8 + CD45RO +, CD3 + CD8 + CD28 + Cell (CTL) effect of the results. However, there was no significant correlation between serum viral load and CD8 lymphocyte subsets in peripheral blood.