【摘要】 目的　探讨Th1 /Th2 (Tc1 /Tc2 )型细胞因子的变化在慢性HBV感染的临床分型中的意义 ,探讨Th1 /Th2 (Tc1 /Tc2 )型细胞在慢性HBV感染中的作用。方法　用PMA和Ionomycin作为刺激剂 ,采用流式细胞仪对慢性HBV感染者外周血CD3 + /CD8+ T细胞和CD3 + /CD8-T细胞内IFN γ和IL 4的表达进行检测 ,比较乙肝病毒携带者、慢性乙型肝炎、活动性肝炎后肝硬化和慢性重症肝炎各组Th1 /Th2 (Tc1 /Tc2 )型细胞因子水平的变化。结果　慢性肝炎、活动性肝炎后肝硬化、慢性重症肝炎患者的Th1 、Tc1 细胞均高于正常对照组和乙肝病毒携带者。慢性重症肝炎组Th1 、Tc1 显著高于慢性肝炎、正常对照组 (P <0 0 1) ,慢性重症肝炎组Tc1 显著高于活动性肝炎后肝硬化组 (P <0 0 5 )。活动性肝炎后肝硬化组Tc1 显著高于正常对照组 (P <0 0 5 )。Th1 、Tc1 细胞随着慢性乙型肝炎肝脏炎症活动的加剧而增高。而Th2 、Tc2 细胞则在各组中均无显著性差异 (P >0 0 5 )。结论　在慢性HBV感染中 ,Th1 和Tc1 细胞数量与肝脏炎症活动严重程度呈正相关 ,提示Th1 和Tc1 细胞在慢性乙型肝炎肝脏病理发生中可能起了重要作用更多还原

【Abstract】 Objective To analyze the expressions of Th 1/Th 2 (Tc 1/Tc 2) cytokines in various clinical types of chronic hepatitis B virus (HBV) infection and to study the possible roles of Th 1/Th 2 (Tc 1/Tc 2) cytokines in chronic HBV infection. Methods Stimulated by phorboe 12 myristate 13 asetate (PMA) /Ionomycin/Monensin, the levels of interleukin 4 (IL 4) and interferon γ (IFN γ) in the CD3 + CD8 + T cells and CD3 + CD8 - T cells of peripheral blood from chronic HBV patients were measured by fluorescence activated cell sorting (FACS). The levels of Th 1/Th 2 (Tc 1/Tc 2) cytokines in asymptomatic carriers (ASC), chronic hepatitis B, active cirrhosis of the liver and chronic severe hepatitis were compared and analyzed. Results The percentages of Th 1 and Tc 1 cells in chronic hepatitis B, active cirrhosis of the liver, and chronic severe hepatitis groups were significantly higher than those in the control and ASC groups. Compared with that in chronic hepatitis B and the normal control groups, the percentage of Th 1 and Tc 1 cells was significantly higher in chronic severe hepatitis ( P <0.01). Meanwhile, the percentage of Tc1 cells was higher in chronic severe hepatitis than that in active cirrhosis of the liver ( P <0.05). The percentage of Tc 1 cells in active cirrhosis of the liver was higher than that in the normal controls ( P <0.05). The increased percentage of Th 1 and Tc 1 cells was positively correlated with the severity of hepatic inflammation. No difference in the percentage of Th 2 and Tc 2 cells was found between HBV infected individuals ( P >0.05). Conclusion There is a positive correlation between Th 1 and Tc 1 cytokines and hepatic inflammatory activity in chronic HBV infected individuals. Th 1 and Tc 1 cells might play an important role in the pathogenesis of chronic hepatitis B.更多还原