乙型肝炎患者T細胞亞群、IL—32水平的變化及其臨床意義分析

熊勛爵

【摘要】 目的：對不同程度乙型肝炎患者血液中的T細胞亞群、IL-32水平進行測定，比較其變化情況并探討其對血清免疫細胞的影響。方法：選取2016年3-12月來本院就診的120例不同程度乙型肝炎患者，同期40例健康體檢的志愿者作為對照組，采用流式細胞儀對T細胞亞群進行檢測，酶聯免疫吸附試驗測定IL-32細胞因子的水平，分別比較不同組別的變化情況。結果：乙型肝炎患者血液中CD4+T細胞的百分比及CD4+/CD8+比值均低于對照組，而CD8+T細胞亞群的百分比高于對照健康組，差異均有統計學意義（P<0.05）。不同程度乙型肝炎組血清中IL-32的水平均高于對照組，差異均有統計學意義（P<0.05）。結論：乙型肝炎患者細胞免疫功能呈現紊亂狀態，IL-32的水平明顯增高可能是參與免疫應答，T細胞亞群比例異常與肝臟的炎癥損傷程度具有相關性。

【關鍵詞】 乙型肝炎； T細胞亞群； IL-32水平

【Abstract】 Objective：To study the changes of T cell subsets and IL-32 levels in blood of different degrees hepatitis B patients，to compare and explore their effect on serum immune cells.Method：From March to December 2016，120 different degrees hepatitis B patients who were treated in our hospital were selected as observation group，40 healthy volunteers were selected as the control group.Test T cells subsets by flow cytometry instrument，and levels of IL-32 cytokines were measured by enzyme-linked immunosorbent assay（ELISA），and the changes of different groups were compared.Result：The percentage of CD4+T cells and CD4+/CD8+ ratio in the blood of patients with hepatitis B were lower than those of control group，while the percentage of CD8+ T cells in the blood of patiensts with hepatitis B was higher than that of control group，the differences were statistically significant（P<0.05）；the serum IL-32 levels of different degrees hepatitis B patients were higher than those in cases of control group，the differences were statistic significant（P<0.05）.Conclusion：The cellular immune function of hepatitis B virus patients is in a disorder state，the increase of IL-32 levels may be related to the severity of inflammatory response，and the degree of T cell subsets ratio anomalies associated with inflammation damage degree of liver.

【Key words】 Hepatitis B； T-cell subsets； IL-32

First-authors address：Jingshan Renhe Hospital of Hubei Province，Jingmen 431899，China

doi：10.3969/j.issn.1674-4985.2017.25.031

乙型肝炎主要是由肝炎病毒群的雙螺旋環狀封閉DNA病毒引起的，是導致死亡最為常見的原因之一。該病具有病程較長久且易復發性等特點，發病率逐年呈現出大幅度增長趨勢，患病人群較廣，本病對患者正常生活及身心健康造成較嚴重影響[1]。有報道稱發揮關鍵的細胞是活化的Th細胞，目前較新發現的Th型細胞可能在肝炎發病進程中扮演重要作用，其被異?；罨筢尫懦龃罅康南嚓P細胞因子主要包括IL-32及IL-23等，有研究報道其患者血清中Th細胞分泌炎癥細胞因子IL-32水平發生變化是引發肝炎的重要因素[2-3]。乙型肝炎病患者由于在機體內的免疫功能呈現低下狀態、持續復制病毒可誘導機體產生各種細胞因子、炎性介質及宿主免疫病理反應復雜作用，進一步最終造成大塊肝組織、肝細胞壞死，發展成重型乙型肝炎甚或肝功及多臟器能衰竭，病亡率較高，有報道稱可達到40%～60%，且預后性較差[4]?！?br>