CAJ | 학술논문

目的：探讨HBeAg阳性和阴性慢性乙型肝炎（CHB）患者肝内免疫活性细胞（CD4＋、CD8＋、CD20＋、CD57＋T淋巴细胞）与肝脏病理及临床的关系。方法选取2008年1月－2013年12月在桂林市第三人民医院住院的70例CHB患者进行肝穿刺活组织检查，其中HBeAg阳性患者38例，HBeAg阴性患者32例。运用免疫组化染色分析肝组织内CD4＋、CD8＋、CD20＋、CD57＋T淋巴细胞的表达，比较不同HBeAg状态患者CD4＋、CD8＋、CD20＋、CD57＋T淋巴细胞与临床相关性。等级资料采用Kruskal－Walls H检验，组间比较采用Nemenyi法，相关性分析采用直线相关分析法。结果 HBeAg阳性和阴性患者的炎症程度到达G3～G4，其肝组织中CD8＋、CD20＋T淋巴细胞的表达均比G1组明显增加（P值均＜0．05）；HBeAg阳性患者炎症程度到达G4、而HBeAg阴性患者炎症程度到达G3，其肝组织中CD4＋T淋巴细胞的表达比G1组明显增加（P值均＜0．05）；在HBeAg阴性患者中CD4＋、CD8＋、CD20＋、CD57＋T淋巴细胞均与ALT水平呈正相关（r值分别为0．353、0．628、0．693、0．540，P值均＜0．05），且CD20＋T淋巴细胞还与HBV DNA水平呈正相关（r＝0．378，P＜0．05）。而在HBeAg阳性患者中只有CD8＋、CD20＋T淋巴细胞与ALT水平呈正相关，与HBV DNA水平无相关性。结论不同HBeAg状态患者肝组织内CD4＋、CD8＋、CD20＋T淋巴细胞表达与肝组织内炎症分级均有明显相关性，但肝内免疫活性细胞与ALT、HBV DNA水平的相关性存在差异。
목적：탐토HBeAg양성화음성만성을형간염（CHB）환자간내면역활성세포（CD4＋、CD8＋、CD20＋、CD57＋T림파세포）여간장병리급림상적관계。방법선취2008년1월－2013년12월재계림시제삼인민의원주원적70례CHB환자진행간천자활조직검사，기중HBeAg양성환자38례，HBeAg음성환자32례。운용면역조화염색분석간조직내CD4＋、CD8＋、CD20＋、CD57＋T림파세포적표체，비교불동HBeAg상태환자CD4＋、CD8＋、CD20＋、CD57＋T림파세포여림상상관성。등급자료채용Kruskal－Walls H검험，조간비교채용Nemenyi법，상관성분석채용직선상관분석법。결과 HBeAg양성화음성환자적염증정도도체G3～G4，기간조직중CD8＋、CD20＋T림파세포적표체균비G1조명현증가（P치균＜0．05）；HBeAg양성환자염증정도도체G4、이HBeAg음성환자염증정도도체G3，기간조직중CD4＋T림파세포적표체비G1조명현증가（P치균＜0．05）；재HBeAg음성환자중CD4＋、CD8＋、CD20＋、CD57＋T림파세포균여ALT수평정정상관（r치분별위0．353、0．628、0．693、0．540，P치균＜0．05），차CD20＋T림파세포환여HBV DNA수평정정상관（r＝0．378，P＜0．05）。이재HBeAg양성환자중지유CD8＋、CD20＋T림파세포여ALT수평정정상관，여HBV DNA수평무상관성。결론불동HBeAg상태환자간조직내CD4＋、CD8＋、CD20＋T림파세포표체여간조직내염증분급균유명현상관성，단간내면역활성세포여ALT、HBV DNA수평적상관성존재차이。
Objective To investigate the relationship of hepatic immune cells (CD4 +,CD8 +,CD20 +,and CD57 +T lymphocytes)with liver pathology and clinical relevance in chronic hepatitis B (CHB)patients with different HBeAg status.Methods A total of 70 CHB pa-tients admitted to our hospital from January 2008 to December 2013 underwent liver biopsy,among whom 38 were HBeAg positive and 32 were HBeAg negative.Immunohistochemistry was used to examine the expression of CD4 +,CD8 +,CD20 +,and CD57 +T lymphocytes in hepatic tissues,and the correlation between their expression and clinical relevance was analyzed in patients with different HBeAg status. Ranked data were analyzed by Kruskal-Walls H test.Comparison between groups was made by Nemenyi test.Correlation analysis was made by linear regression method.Results When inflammation reached to the level of G3 -G4 in patients with either positive or negative HBeAg,the expression of hepatic CD8 +and CD20 +cells in them was significantly higher than that in patients with inflammation level of G1 (all P<0.05).When the levels of inflammation reached G4 in patients with positive HBeAg and G3 in those with negative HBeAg,the ex-pression of hepatic CD4 +cells was significantly higher than that in patients with G1 inflammation (all P<0.05).In patients with negative HBeAg,the CD4 +,CD8 +,CD20 +,and CD57 +lymphocytes all showed a positive correlation with alanine aminotransferase (ALT)level (r=0.353,0.628,0.693,and 0.540,respectively;all P<0.05).In addition,CD20 +lymphocytes also showed a positive correlation with hepatitis B virus (HBV)DNA (r=0.378,P<0.05).However,in patients with positive HBeAg,only CD8 +and CD20 +lympho-cytes showed a positive correlation with ALT level,and no correlation was found between all lymphocyte populations and HBV DNA.Con-clusion The expression of CD4+,CD8 +,and CD20+lymphocytes was significantly correlated with the grade of inflammation in hepatic tis-sues in patients with different HBeAg status,whereas the correlations between hepatic immune cells and levels of ALT and HBV DNA vary.