海南医学
海南醫學
해남의학
HAINAN MEDICAL JOURNAL
2014年
24期
3658-3660
,共3页
苑文雯%王晗%朱剑功%王大刚%杨宁%李沛然%李妍%耿伟%何叶莉%郭桐生
苑文雯%王晗%硃劍功%王大剛%楊寧%李沛然%李妍%耿偉%何葉莉%郭桐生
원문문%왕함%주검공%왕대강%양저%리패연%리연%경위%하협리%곽동생
乙型肝炎病毒%T淋巴细胞%免疫应答%免疫调节治疗
乙型肝炎病毒%T淋巴細胞%免疫應答%免疫調節治療
을형간염병독%T림파세포%면역응답%면역조절치료
Hepatitis B virus%T cell%Immune response%Immunomodulatory therapy
目的：探讨T细胞免疫应答水平的检测在乙型肝炎病毒感染者诊断以及免疫调节治疗中的价值。方法选择2013年7月至2014年2月就诊并符合纳入标准的40例患者，于治疗前及免疫调节治疗1个月、3个月采集外周血，同时选择同期健康体检者40例作为对照，分别对血清ALT、AST及T淋巴细胞亚群进行检测及统计学分析。结果与对照组比较，慢性乙型肝炎患者外周血CD3+T、CD4+T淋巴细胞亚群百分数、CD4+/CD8+T细胞比值显著降低(P<0.01)，免疫调节治疗过程中，各指标均逐渐升高(P<0.01)。而慢性乙型肝炎患者血清ALT、AST及外周血CD8+T淋巴细胞亚群百分数水平则显著高于对照组(P<0.01)，经免疫调节治疗，各指标水平逐渐下降(P<0.01)。慢性乙型肝炎血清中ALT、AST水平与CD8+T淋巴细胞亚群百分数(P<0.01)呈正相关；与CD4+/CD8+T比值(P<0.01)呈明显负相关。结论乙型肝炎病毒感染患者感染期及免疫调节治疗不同阶段T细胞免疫应答水平不同，对乙型肝炎病毒感染者的诊断以及免疫调节治疗有指导意义。
目的：探討T細胞免疫應答水平的檢測在乙型肝炎病毒感染者診斷以及免疫調節治療中的價值。方法選擇2013年7月至2014年2月就診併符閤納入標準的40例患者，于治療前及免疫調節治療1箇月、3箇月採集外週血，同時選擇同期健康體檢者40例作為對照，分彆對血清ALT、AST及T淋巴細胞亞群進行檢測及統計學分析。結果與對照組比較，慢性乙型肝炎患者外週血CD3+T、CD4+T淋巴細胞亞群百分數、CD4+/CD8+T細胞比值顯著降低(P<0.01)，免疫調節治療過程中，各指標均逐漸升高(P<0.01)。而慢性乙型肝炎患者血清ALT、AST及外週血CD8+T淋巴細胞亞群百分數水平則顯著高于對照組(P<0.01)，經免疫調節治療，各指標水平逐漸下降(P<0.01)。慢性乙型肝炎血清中ALT、AST水平與CD8+T淋巴細胞亞群百分數(P<0.01)呈正相關；與CD4+/CD8+T比值(P<0.01)呈明顯負相關。結論乙型肝炎病毒感染患者感染期及免疫調節治療不同階段T細胞免疫應答水平不同，對乙型肝炎病毒感染者的診斷以及免疫調節治療有指導意義。
목적：탐토T세포면역응답수평적검측재을형간염병독감염자진단이급면역조절치료중적개치。방법선택2013년7월지2014년2월취진병부합납입표준적40례환자，우치료전급면역조절치료1개월、3개월채집외주혈，동시선택동기건강체검자40례작위대조，분별대혈청ALT、AST급T림파세포아군진행검측급통계학분석。결과여대조조비교，만성을형간염환자외주혈CD3+T、CD4+T림파세포아군백분수、CD4+/CD8+T세포비치현저강저(P<0.01)，면역조절치료과정중，각지표균축점승고(P<0.01)。이만성을형간염환자혈청ALT、AST급외주혈CD8+T림파세포아군백분수수평칙현저고우대조조(P<0.01)，경면역조절치료，각지표수평축점하강(P<0.01)。만성을형간염혈청중ALT、AST수평여CD8+T림파세포아군백분수(P<0.01)정정상관；여CD4+/CD8+T비치(P<0.01)정명현부상관。결론을형간염병독감염환자감염기급면역조절치료불동계단T세포면역응답수평불동，대을형간염병독감염자적진단이급면역조절치료유지도의의。
Objective To evaluate the value of T cell's immune response in the diagnosis of hepatitis B virus infection and its effect on immunomodulatory therapy. Methods A total of 40 patients who had hepatitis B and have been treated at the hospital from Jul. 2013 to Feb. 2014 were selected as the objects (the study group). The peripheral blood of the patients was collected before immunomodulatory treatment, 1 month and 3 months after treatment. At the same time, 40 healthy volunteers were selected as control group (the control group). Alanine aminotransferase (ALT), aspertate Aminotransferase (AST) and T-cell subsets were detected and analyzed statistically. Results Compared to the control group, the percentage of CD3+T and CD4+T cell, the ratio of CD4+/CD8+T cell in the study group were signif-icantly decreased (P<0.01). During the immunomodulatory treatment, all the indexes increased gradually (P<0.01). However, ALT, AST and the percentage of CD8+T cell were significantly increased in the study group (P<0.01), and they were significantly decreased after treatment (P<0.01). ALT, AST level in the study group were positively correlat-ed with the percentage of CD8+T cell (P<0.01), and were negative correlated with the ratio of CD4+/CD8+ T cell (P<0.01). Conclusion The patients in hepatitis B virus infection stage and different stages of immunomodulatory thera-py vary in T cell's immune response, which can, to a certain extent, guide hepatitis B diagnosis and clinical treatment with immunomodulatory.
