【摘要】 目的研究慢性乙肝(CHB)合并EB病毒(EBV)感染患者外周血单个核细胞中Toll样受体4(TLR4)、Toll样受体9(TLR9)表达水平及临床意义。方法选取2017年3月至2020年3月江苏省中医院收治的54例CHB合并EBV感染患者作为研究对象,另选取本院同期收治的25例CHB未合并EBV感染患者作为对照组1,25例仅感染EBV病毒患者作为对照组2。检测所有患者丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、碱性磷酸酶(ALP)水平,采用流式细胞术检测TLR4、TLR9阳性表达情况,采用Spearman分析数据间相关性,采用Kaplan-Meier生存曲线对比两组患者生存情况。结果研究组患者外周血单个核细胞TLR4、TLR9阳性表达情况显著高于两组对照组,差异有统计学意义(P<0.05);研究组患者的血ALT、AST、TBIL、DBIL、IBIL、ALP水平均明显高于两组对照组,差异有统计学意义(P<0.05);TLR4阳性表达与血ALT、AST、DBIL及ALP水平呈正相关,TLR9阳性表达与血ALT、AST、IBIL及ALP水平呈正相关;TLR4、TLR9高表达患者疾病进展率高于低表达患者,差异有统计学意义(c2=6.135、5.684,P<0.05);TLR4、TLR9高表达患者15个月生存率较低表达患者比较,差异无统计学意义(P>0.05)。结论 CHB合并EBV感染患者外周血单个核细胞TLR4、TLR9阳性表达增多,与肝功能损伤加重和疾病进展相关。更多还原

【Abstract】 Objective To explore the expression levels and clinical significance of Toll-like receptor 4（TLR4）and Toll-like receptor 9（TLR9）in peripheral blood mononuclear cells of patients with chronic hepatitis B（CHB）combined with Epstein-Barr virus（EBV）infection. Methods 54 CHB patients with EBV infection who were admitted to Jiangsu Provincial Hospital of Traditional Chinese Medicine from March 2017 to March 2020 were selected as the research objects,and 25 CHB patients without EBV infection were selected as the control group I,25 patient with EBV infection were selected as the control group II who admitted to the hospital during the same period. All the patients were tested for alanine aminotransferase.（ALT）,aspartate aminotransferase（AST）,total bilirubin（TBIL）,direct bilirubin（DBIL）,indirect bilirubin（IBIL）,alkaline phosphatase（ALP）levels. Flow cytometry was used to detect the positive expression of TLR4 and TLR9. Spearman was used to analyze the correlation between the data,and the Kaplan-Meier survival curvewas used to compare the survival of the two groups of patients. Results The positive expression of TLR4 and TLR9 in peripheral blood mononuclear cells from the study group was significantly higher than that from the control groups（P<0.05）. The blood ALT,AST,TBIL,DBIL,IBIL,and ALP levels in the study group were significantly higher than those in the control groups（P<0.05）. The positive expression of TLR4 is positively correlated with blood ALT,AST,DBIL and ALP levels,and the positive expression of TLR9 is positively correlated with blood ALT,AST,IBIL and ALP levels. The disease progression rate of patients with high expression of TLR4 and TLR9 was higher than that of patients with low expression,and the difference was statistically significant（c2=6.135,5.684,P<0.05）. There was no significant difference in the 15-month survival rate of patients with high TLR4 and TLR9 expression compared with patients with low expression（P>0.05）.Conclusion The positive expression of TLR4 and TLR9 in peripheral blood mononuclear cells of CHB patients with EBV infection increases,which is related to the aggravation of liver damage and disease progression.更多还原