【摘要】 目的研究聚乙二醇干扰素(PEG-IFN)治疗慢性丙型肝炎(CHC)患者T细胞亚群及其表面程序性死亡受体-1(PD-1)的表达、B细胞的变化。方法从接受PEG-IFNα-2a抗病毒治疗的CHC患者中选择快速病毒学应答者(RVR)20例、无应答者(NR)20例,采用流式细胞仪分别检测其治疗前及治疗12周时外周血T细胞亚群及其表面PD-1的表达、B细胞的表达水平,并以20名健康体检者作为正常对照组,分析其表达水平差异及临床意义。结果 CHC患者治疗前与正常对照组比较,CD4+T细胞增高,CD4+T/CD8+T增高,CD19+B细胞增高,CD8+T细胞降低,T细胞亚群(CD4+/CD8+)表面PD-1的表达明显升高,差异均有统计学意义(P<0.01)。治疗12周时NR组与RVR组比较,CD4+T细胞增高,CD4+T/CD8+T增高,CD19+B细胞增高,CD8+T细胞降低,T细胞亚群CD4+/CD8+上表达的PD-1升高,差异均有统计学意义(P<0.05)。结论 CHC患者T细胞亚群失衡及B淋巴细胞升高,经PEG-IFN治疗后,其免疫功能得到一定恢复。PD-1的高表达与丙肝病毒复制有关,可能是导致T淋巴细胞应答能力下降的重要原因。更多还原

【Abstract】 Objective To study the changing expression levels on T cell subsets, programmed death-1(PD-1) and B cells of chronic hepatitis C(CHC)patients during pegylated interferon(PEG-IFN) therapy. Methods All subjects were selected from CHC patients by treatment with PEG-IFN α-2a, of which 20 cases achieved rapid virological response(RVR), 20 cases achieved null response(NR). The expression levels of T cell subsets, PD-1 and B cells in peripheral blood of all subjects before and 12 weeks after PEG-IFN therapy were detected by flow cytometry method. And 20 healthy controls were comprised of control group in this study. The differences and their clinical significance were analyzed. Results Compared with those of normal controls, the expression levels of CD4+T, CD4+/ CD8+and CD19+B of CHC patients before therapy were higher, the expression levels of CD8+T were lower, and the expression density of PD-1 on T cell subsets(CD4+/ CD8+) was significantly higher,there was significantly difference in all results(P<0.01). Compared with those of RVR group, the expression levels of CD4+T, CD4+/ CD8+and CD19+B of NR group after 12 weeks therapy were higher, the expression levels of CD8+T were lower(P<0.05), and the expression density of PD-1 on T cell subsets(CD4+/ CD8+) was higher,there is a significantly statistical difference(P<0.01). Conclusion It may exist that the unbalance of the T cell subsets and B cells of CHC patients, their immune function have been recovered after PEG-IFN therapy. The higher expression levels of PD-1 may be associated with the replication of HCV-RNA and it may be an important reason for the response decline of T cell.更多还原