CAJ | 학술논문

目的：探讨外周血T淋巴细胞比例特点与HBV相关慢加急性肝衰竭正虚机制的关系。方法选取2010年1月-2012年12月在本院就诊的HBV相关慢加急性肝衰竭早期患者（肝衰竭组）40例与慢性乙型肝炎（CHB）患者（CHB组）50例，以门诊同期健康体检者20例为健康对照组，应用流式细胞仪测定外周血CD3＋T淋巴细胞、CD4＋和CD8＋T淋巴细胞比值、CD4＋CD25＋调节性T细胞所占比例，比较组间差异。3组间比较采用方差分析。结果肝衰竭组外周血CD3＋T淋巴细胞（34．12％±22．33％）、CD4＋/CD8＋比值（1．78±1．25）和 CD4＋CD25＋调节性 T细胞（0．83％±1．00％）所占比例与健康对照组（分别为50．31％±12.09％、1．32％±0．31％、2．93％±1．31％）和CHB组（分别为49．72％±20.11％、1．31％±0．52％、3．17％±2．29％）相比较均下降，差异有统计学意义（P＜0．05）。结论 HBV相关慢加急性肝衰竭一旦形成，外周血T淋巴细胞及相关效应T淋巴细胞便处于“耗损”状态，体现其“正虚”的病机特点。
목적：탐토외주혈T림파세포비례특점여HBV상관만가급성간쇠갈정허궤제적관계。방법선취2010년1월-2012년12월재본원취진적HBV상관만가급성간쇠갈조기환자（간쇠갈조）40례여만성을형간염（CHB）환자（CHB조）50례，이문진동기건강체검자20례위건강대조조，응용류식세포의측정외주혈CD3＋T림파세포、CD4＋화CD8＋T림파세포비치、CD4＋CD25＋조절성T세포소점비례，비교조간차이。3조간비교채용방차분석。결과간쇠갈조외주혈CD3＋T림파세포（34．12％±22．33％）、CD4＋/CD8＋비치（1．78±1．25）화 CD4＋CD25＋조절성 T세포（0．83％±1．00％）소점비례여건강대조조（분별위50．31％±12.09％、1．32％±0．31％、2．93％±1．31％）화CHB조（분별위49．72％±20.11％、1．31％±0．52％、3．17％±2．29％）상비교균하강，차이유통계학의의（P＜0．05）。결론 HBV상관만가급성간쇠갈일단형성，외주혈T림파세포급상관효응T림파세포편처우“모손”상태，체현기“정허”적병궤특점。
Objective To investigate the relationship between percentages of T lymphocytes in peripheral blood and deficiency of vital qi in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF).Methods Forty patients with early-stage HBV-ACLF were enrolled as liver failure group,and 50 patients with chronic hepatitis B (CHB)as CHB group;20 healthy subjects who underwent physical examination in the clinic during the same period were selected as control group.Flow cytometry was used to determine the percentages of CD3 +T lymphocytes,CD4+and CD8 +T lymphocytes,and CD4+CD25 +regulatory T cells (Tregs)in peripheral blood,as well as CD4+/CD8 +ratio,and the three groups were compared in this regard by analysis of variance.Results Compared with the control group and CHB group,the liver failure group had a significantly decreased percentage of CD3 +T lymphocytes in peripheral blood (34.12%±22.33%vs 50.31%±12.09%and 49.72%±20.11%,P<0.05),a significantly increased CD4+/CD8 +ratio (1.78 ±1.25 vs 1.32 ±0.31 and 1.31 ±0.52,P<0.05),and a significantly decreased percentage of CD4+CD25 +Tregs in peripheral blood (0.83%±1.00% vs 2.93%± 1.31%and 3.17%±2.29%,P<0.05).Conclusion Once HBV -ACLF develops,T lymphocyte cells in peripheral blood and related effector T lymphocytes are “exhausted”,which reveals that the characteristics of its pathogenesis is“deficiency of vital qi”.