【摘要】 目的探讨辅助性T细胞17(Th17)在不同程度HBV感染者中的表达情况及其与HBV-DNA和ALT的关系。方法采用流式细胞仪检测86例HBV感染者(中度慢性乙型肝炎患者31例,重度慢性乙型肝炎患者25例,HBV相关性肝硬化患者16例,HBV相关性肝癌患者14例)和22例健康者外周血中Th17占CD4+T细胞的比例、白细胞介素17(IL-17)的水平,同时检测ALT及HBV-DNA水平。结果不同程度HBV感染者外周血Th17细胞占CD4+T细胞的比例和IL-17、ALT水平均明显高于健康对照组(P<0.05)。中度和重度慢性乙型肝炎组患者外周血Th17细胞占CD4+T细胞的比例及IL-17的表达水平均明显低于HBV相关性肝硬化组、HBV相关性肝癌组(P<0.05),但中度和重度慢性乙型肝炎组组间比较,差异无统计学意义(P>0.05)。HBV相关性肝硬化组患者的Th17细胞占CD4+T细胞的比例及IL-17的表达水平亦显著低于HBV相关性肝癌组(P<0.05)。不同程度HBV感染者外周血Th17细胞占CD4+T细胞的比例与HBV-DNA水平呈负相关(P<0.05),与ALT呈正相关(P<0.05)。结论不同程度HBV感染者外周血中Th17细胞及IL-17表达失调,增多的Th17细胞可能促进了肝细胞的损伤及炎症,并与HBV感染病情进展密切相关。更多还原

【Abstract】 Objective To investigate the expression of T helper cell 17( Thl7) in the patients with different degrees of HBV infection and its correlation with HBV-DNA and ALT. Methods A total of 86 patients with HBV infection[including 31 with moderate chronic hepatitis B( CHB),25 with severe CHB,16 with HBV-related cirrhosis and 14 with HBV-related liver cancer] and 22 healthy individuals were enrolled. Flow cytometry was used to detect the ratio of Th17 to CD4+T cell,the levels of interleukin 17( IL-17) and ALT in the peripheral blood in all subjects,and the level of HBV-DNA was detected as well. Results The ratio of Th17 to CD4+T cells,the levels of IL-17 and ALT in the patients with different degrees of HBV infection were significantly higher than those in the healthy control group( P < 0. 05). Patients with moderate or severe CHB had significantly lower ratio of Th17 to CD4+T cells and significantly lower expression level of IL-17 compared to patients with HBV-related cirrhosis or HBV-related liver cancer( P < 0. 05),but there was no significant difference in the ratio or IL-17 expression level between patients with moderate CHB and patients with severe CHB( P > 0. 05). Patients with HBV-related cirrhosis had significantly lower ratio of Th17 to CD4+T cells and significantly lower expression level of IL-17 compared to patients with HBV-related liver cancer( P < 0. 05). In the patients with different degrees of HBV infection,the ratio of Th17 to CD4+T cells in the peripheral blood negatively correlated with the level of HBV-DNA( P < 0. 05),and positively correlated with ALT( P < 0. 05). Conclusion For the patients with different degrees of HBV infection,the expressions of Th17 cells and IL-17 in the peripheral blood are in disorder. The increase of Th17 cells might promote the damage and inflammation of liver cells,and is closely related to the disease progression of HBV infection.更多还原