【摘要】 目的探讨慢性乙型肝炎患者外周血髓系抑制性细胞(myeloid-derived suppressor cells,MDSCs)在疾病进展中的临床意义。方法选取在广州市第八人民医院接受抗病毒治疗的慢性乙型肝炎患者16例及19例健康对照者,用流式细胞术检测外周血单核细胞(PBMC)中MDSCs的比例,并动态检测该比例在核苷(酸)类似物(NAs)抗病毒治疗12周、24周后的变化特征,用Spearman相关法分析MDSCs比例与血清HBV DNA载量、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和总胆红素(TBIL)等指标之间的相关性。统计分析采用均数t检验,MDSCs水平采用单因素方差分析检验,P<0.05为差异有统计学意义。结果慢性乙型肝炎患者外周血MDSCs表型为HLADR-/lowCD11b+CD33+的细胞群其主要为CD14+的单核细胞型。其比例为(1.4±0.27)%,明显高于健康对照组(0.53±0.06)%,(P<0.01);抗病毒治疗12周后其比例为(1.33±0.26)%、24周后其比例为(1.82±0.48)%。MDSCs的比例与治疗前比较差异无统计学意义(P=0.778,P=0.452)。横断面比较分析结果显示MDSCs水平与HBV DNA无相关性(r=-0.14,P=0.60),但与ALT(r=0.621,P=0.01)、AST(r=0.612,P=0.012)、TBIL(r=0.717,P=0.003)呈显著正相关。结论慢性乙型肝炎患者外周血MDSCs比例在一定程度上反映慢性乙型肝炎病情。更多还原

【Abstract】 Objective To evaluate the clinical significance of myeloid-derived suppressor cells(MDSCs)in the progression of chronic hepatitis B(CHB)by comparing MDSCs ratios before and after antiviral therapy and analyzing the associations between MDSCs levels and relevant clinical indexes.Methods The ratios of MDSCs in peripheral blood mononuclear cells(PBMCs)in 16 CHB patients and 19 healthy individuals were detected by flow cytometry.The dynamic changes of MDSCs in CHB patients were monitored at 12-and 24-week time points after taking nucleoside analogues for anti-viral therapy.In addition,the correlations between MDSCs ratios and some clinical indicators such as serum HBV DNA,alanine aminotransferase(ALT),aspartate amino-transferase(AST)and total bilirubin(TBIL)were further analyzed by Spearman correlation analysis.Results The HLADR-/lowCD11b+CD33+MDSCs in CHB patients were found mainly in CD14+monocytes with the ratio as 1.46% ±0.27%,which was significantly higher than in the healthy controls(0.53±0.06)%(P<0.01).However,no significant differences were found between the ratio of MDSCs in CHB patients before and 12weeks(1.33%±0.26%,P=0.778)and 24weeks(1.82%±0.48%,P=0.452)after antiviral treatment.No significant correlation was found between MDSCs level and HBV DNA level(r=-0.14,P=0.60);however,the level of MDSCs correlated positively with the levels of ALT(r=0.621,P=0.010),AST(r=0.612,P=0.012)and TBIL(r=0.717,P=0.003).Conclusions The ratio of MDSCs in PBMCs may reflect the disease status of chronic hepatitis B infection.更多还原