【摘要】 目的 探讨自体乙肝疫苗致敏的树突状细胞(DC)回输慢性乙型肝炎(CHB)患者后的免疫应答效果。方法取患者外周血20ml分离单个核细胞,加入重组人粒细胞-巨噬细胞集落刺激因子(rGM-CSF)和白细胞介素4(IL-4)进行DC体外扩增,于培养第5天加入50μg／ml乙型肝炎疫苗,7天收获细胞。34例慢性乙肝患者根据年龄和感染病毒时间分为治疗1、2、3组,皮内回输DC;20例对照组CHB注射等量生理盐水,与治疗组均每周一次,连续8次。于回输DC后2周检测患者血清HBV-DNA含量及外周血CD3+、CD4+、CD8+T淋巴细胞。结果 3个治疗组患者回输DC后血清HBV-DNA含量拷贝数均较对照组及回输前显著降低(P<0.01),总应答率58.8％(20／34),对照组输注前后没有明显变化(P>0.05);治疗1组与3组相比HBV-DNA定量拷贝数降低幅度有显著性差异(P<0.01),治疗1组与2组、2组与3组相比均无显著性差异(P>0.05)。回输DC后患者CD4+细胞较回输前增高显著(P<0.01),CD3+、CD8+细胞增高不明显(P>0.05)。结论 经乙型肝炎疫苗致敏的DC回输CHB患者后可产生明显应答,且应答程度与患者感染病毒时间和／或年龄有一定关系。更多还原

【Abstract】 Objective To investigate the immunological effect of DCs on patients with chronic hepatitis B. Methods Peripheral blood of patients with chronic hepatitis B.DCs prodiferated from PBMCs by adding rhGM - CSF and IL-4 were cultured for seven davs.On the fifth day, DCs were added to 50μg/ml hepatitis B vaccine. 34 patients with hepatitis B injected by DCs, regarded as 3 observation groups, for eight times wddkly, while the 20 patients in control group given equal volum NS. HBV - DNA contents in the serum and T cell of CE3+ , CD4 + , CD8 + in the peripheral blood of patients were tested after the injection course. Result After treatment of DCs, the copies of HBV - DNA in the serum decreased greatly(P<0.01) and the total effective rate is 58.8% (20/34) .No significant changes were found after injection of DCs in the control group( P > 0.05) . There was great difference in the copies of HBV - DNA between the first observation group and the third observation group( P < 0.01). The others were not significant different (P > 0.05). After injection of DCs, T cells of CD4+ decreased greatly(P < 0.01), while T cells of CD3+ , CD8 + were not significant different( P > 0.05) . Conclusion The patients with HBV have significant response by the injection of DCs. And degree of response may be related to the time of infection virus and/or the age of patient.更多还原