CAJ | 학술논문

目的：了解 HBV 感染后肝细胞不同程度损伤的患者外周血中辅助性 T 细胞17（Th17）和调节性 T 细胞（Treg）的比例变化。方法选取乙型肝炎患者109例，其中无症状 HBV 携带者32例（ASC 组）、慢性乙型肝炎47例（CHB 组）、肝细胞癌伴活动性肝炎30例（HCC 组）。另选健康体检者25名作为对照组。采用流式细胞术检测外周血Th17细胞和 Treg 细胞以及 CD3＋、CD3＋ CD4＋ T 细胞含量，自动生化分析仪检测血清 ALT、AST。结果与对照组 Treg细胞比较，ASC 组稍高，但差异无统计学意义（t ＝0．809，P ＞0．05）；CHB 组、HCC 组升高明显（t ＝2．988、7．569，P ＜0．05），均高于 ASC 组（t＝2．456、7．177，P ＜0．05）；HCC 组患者外周血 Treg 细胞比例高于 CHB 组，差异有统计学意义（t＝4．057，P ＜0．05）；外周血 Treg 细胞比例与血清 ALT 和 AST 水平呈正相关（r ＝0．546、0．587，P ＜0．01）。与对照组Th17细胞比较，ASC 组略有升高，但差异无统计学意义（t ＝1．459，P ＞0．05）；CHB 组和 HCC 组均明显升高（t ＝3．910、6．725，P ＜0．05），且 HCC 组高于 CHB 组（t＝6．580，P ＜0．01）；外周血 Th17细胞比例与血清 ALT 和 AST 水平呈正相关（r＝0．546、0．617，P ＜0．01）。在 Th17／Treg 比值上，外周血 Th17细胞和 Treg 细胞在 HBV 感染者中呈正相关（r ＝0．487，P ＜0．05），对照组 Th17／Treg 比值最低（0．15％±0．14％），CHB 组、HCC 组升高明显（t ＝2．015、5．056，P ＜0．05），Th17升高更为明显。结论随着 HBV 感染患者病情的发展，外周血 Th17／Treg 细胞比例升高，Th17、Treg 细胞构成免疫的平衡状态被破坏，机体受到 Th17细胞介导的炎性反应，造成肝细胞损伤。
목적：료해 HBV 감염후간세포불동정도손상적환자외주혈중보조성 T 세포17（Th17）화조절성 T 세포（Treg）적비례변화。방법선취을형간염환자109례，기중무증상 HBV 휴대자32례（ASC 조）、만성을형간염47례（CHB 조）、간세포암반활동성간염30례（HCC 조）。령선건강체검자25명작위대조조。채용류식세포술검측외주혈Th17세포화 Treg 세포이급 CD3＋、CD3＋ CD4＋ T 세포함량，자동생화분석의검측혈청 ALT、AST。결과여대조조 Treg세포비교，ASC 조초고，단차이무통계학의의（t ＝0．809，P ＞0．05）；CHB 조、HCC 조승고명현（t ＝2．988、7．569，P ＜0．05），균고우 ASC 조（t＝2．456、7．177，P ＜0．05）；HCC 조환자외주혈 Treg 세포비례고우 CHB 조，차이유통계학의의（t＝4．057，P ＜0．05）；외주혈 Treg 세포비례여혈청 ALT 화 AST 수평정정상관（r ＝0．546、0．587，P ＜0．01）。여대조조Th17세포비교，ASC 조략유승고，단차이무통계학의의（t ＝1．459，P ＞0．05）；CHB 조화 HCC 조균명현승고（t ＝3．910、6．725，P ＜0．05），차 HCC 조고우 CHB 조（t＝6．580，P ＜0．01）；외주혈 Th17세포비례여혈청 ALT 화 AST 수평정정상관（r＝0．546、0．617，P ＜0．01）。재 Th17／Treg 비치상，외주혈 Th17세포화 Treg 세포재 HBV 감염자중정정상관（r ＝0．487，P ＜0．05），대조조 Th17／Treg 비치최저（0．15％±0．14％），CHB 조、HCC 조승고명현（t ＝2．015、5．056，P ＜0．05），Th17승고경위명현。결론수착 HBV 감염환자병정적발전，외주혈 Th17／Treg 세포비례승고，Th17、Treg 세포구성면역적평형상태피파배，궤체수도 Th17세포개도적염성반응，조성간세포손상。
Objective To investigate the changes of T helper 17 (Th17)cells and regulatory T (Treg)cells in the peripheral blood of hepatitis B virus(HBV)infected patients and their correlations with liver injury.Methods One hundred and nine cases of hepatitis B patients were chosen in our hospital from March 2010 to January 2013 and were divided into four groups in accordance with the condition of diseases.The peripheral blood of 32 asymptomatic HBV carriers (ASC group),47 chronic hepatitis B patients (CHB group),30 hepatocellular carcinoma patients (HCC group)and 30 healthy controls (control group)were collected.The percentages of Th17 and Treg cells were detected by flow cytometry.Alanine aminotransferase (ALT)and aspartate aminotransferase (AST)were detected by automatic biochemistry analyzer.Results Compared with control group,the percentages of both Treg and Th17 cells in the peripheral blood of ASC group were higher,but no statistical difference was detected (t =0.809,P >0.05 for Treg cells;t =1 .459,P >0.05 for Th17 cells, respectively).While significant increase of percentages of Treg cells and Th17 cells in CHB group and HCC group was found(t=2.988,7.569,P <0.05 for Treg cells;t=3.910,6.725,P <0.05 for Th17 cells,respectively).And Treg cells increase in HCC group was higher than that in CHB group (t=6.580,P <0.01).Treg cells and Th17 cells were correlated positively with ALT and AST(r=0.546,0.587,P <0.01 for Treg cells;r =0.546、0.617,P <0.01 for Th17 cells),and Th17 cell percentage was positively correlated with Treg cell percentage (r =0.487,P <0.01).The rate of Th17/Treg in control group was the lowest (0.15%±0.14%),while significantly higher Th17/Treg ratio in CHB group and HCC group were observed (t=2.015,5.056,P <0.05).Conclusion With the development of HBV infection,the percentages of Th17 and Treg cells increased.The destruetion of the immune balance leads to the increased of Th17 cells that induced immune injury and induce the inflammation of liver cells.