摘要
目的评价慢性乙型病毒性肝炎(CHB)合并爱泼斯坦-巴尔病毒(EBV)感染患者外周血双阴性T淋巴细胞(DN T)、滤泡辅助性T细胞(Tfh)和CD4+T细胞水平以及CD4+/CD8+比值(CD4-CD8 Ratio)变化,并分析其与肝功能各项指标的相关性,探讨其临床意义。方法收集2021年10月至2023年8月南京中医药大学附属医院30例CHB合并原发性EBV感染患者(CHB+EBV组)、30例CHB患者(CHB组)及30名健康对照者(对照组)的外周血,采用流式细胞术检测外周血单个核细胞(PBMC)中Tfh细胞和DN T细胞、CD4+细胞、CD8+的水平,使用生化分析仪检测肝功能指标:天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、碱性磷酸酶(ALP)、直接胆红素(DBIL)、总胆红素(TBIL)、间接胆红素(IBIL)。结果外周血Tfh细胞水平:CHB+EBV组>CHB组>对照组,外周血DN T细胞水平:CHB组>CHB+EBV组>对照组,外周血CD4+T细胞水平:对照组>CHB组>CHB+EBV组,CD4+/CD8+比值:对照组>CHB组>CHB+EBV组,差异有统计学意义(P<0.05)。CHB+EBV组患者血液中ALT、AST、TBIL、DBIL、IBIL和ALP水平均明显高于CHB组和对照组(P<0.05)。相关性分析结果显示,患者外周血Tfh细胞与血液中ALT、AST、ALP、TBIL、DBIL和IBIL呈正相关(P<0.05)。DNT细胞与血ALT,AST,TBIL,DBIL和IBIL呈正相关(P<0.05),但与ALP无明显相关性(P>0.05)。CD4+细胞及CD4+/CD8+值与血ALT,AST,ALP,TBIL,DBIL及IBIL呈负相关(P<0.05)。结论双阴性T淋巴细胞和滤泡辅助性T细胞参与了CHB合并EBV感染免疫进程,且与患者肝损害有关。
Objective To investigate peripheral blood double negative T cells(DN T),follicular helper T cells,and follicular helper T cells in patients with chronic hepatitis B(CHB)and EBV infection.The changes of Tfh)level,CD4+T cell(CD4-positive T-lymphocyte)level and CD4+/CD8+ratio(CD4,CD8 ratio)was analyzed and their correlation with various indicators of liver function was discussed,and their clinical significance was discussed.Methods The peripheral blood of 30 CHB patients with primary EBV infection(CHB+EBV group),30 CHB patients(CHB group)and 30 healthy controls(control group)at the Affiliated Hospital of Nanjing University of Chinese Medicine from October 2021 to August 2023 were collected.The levels of Tfh cells,DN T cells,CD4+cells and CD8+in peripheral blood mononuclear cells(PBMC)were detected by flow cytometry.Biochemical analyzer was used to detect liver function indexes:aspartate aminotransferase(AST),alanine aminotransferase(ALT),alkaline phosphatase(ALP),direct bilirubin(DBIL),total bilirubin(TBIL),indirect bilirubin(IBIL).Result Peripheral blood Tfh cell level:CHB+EBV group>CHB group>control group,peripheral blood DN T cell level:CHB group>CHB+EBV group>control group,pe-ripheral blood CD4+T cell level:control group>CHB group>CHB+EBV group,CD4+/CD8+ratio:control group>CHB group>CHB+EBV group,the difference was statistically significant(P<0.05).The levels of ALT,AST,TBIL,DBIL,IBIL,and ALP in the CHB+EBV group were significantly higher than those in the CHB group and the control group(P<0.05).Correlation analysis showed that Tfh cells in peripheral blood were positively correlated with ALT,AST,ALP,TBIL,DBIL,and IBIL in the blood(P<0.05).DN T cells were positively correlated with ALT,AST,TBIL,DBIL and IBIL(P<0.05),but not with ALP(P>0.05).CD4+cells and CD4+/CD8+values were negatively correlated with blood ALT,AST,ALP,TBIL,DBIL,and IBIL(P<0.05).Conclusion Double negative T lymphocytes and follicular helper T cells play a role in the immune response to CHB with EBV infection and are related to liver damage in affected patients.
作者
王佳
高峰
严士海
杨学文
张莉
WANG Jia;GAO Feng;YAN Shihai;YANG Xuewen;ZHANG Li(Nanjing University of Chinse Medicine,Jiangsu province of Traditional Chinase Medicine,Nanjing,Jiangsu,China,210029)
出处
《分子诊断与治疗杂志》
2024年第10期1914-1917,1922,共5页
Journal of Molecular Diagnostics and Therapy
