【摘要】 目的:通过检测乙型肝炎患者外周血单核细胞各亚群分布情况以及HLA-DR表达水平,探讨慢性乙型肝炎患者外周血中CD14+CD16+单核细胞及HLA-DR的表达特点,以及与疾病进程之间的关系。方法:利用流式细胞仪(FCM)检测50例慢性乙型肝炎患者,其中21例免疫耐受(IT)患者、29例免疫活化(IA)患者,及31例正常人外周血CD14、CD16、HLA-DR的表达。同时调查肝功能、乙肝五项和血清HBV DNA等相应临床资料。结果:免疫活化组(IA)的CD14+CD16+亚群比率明显高于正常对照组和免疫耐受组(IT)(P<0.01);单核细胞CD14+CD16+亚群HLA-DR表达明显高于CD14++CD16-亚群(P<0.01);乙型肝炎患者CD14+CD16+单核细胞比率与ALT呈正相关(r=0.876,P<0.01),与HBV DNA载量成负相关(r=-0.267,P<0.01)。结论:CD14+CD16+单核细胞可能在乙型肝炎患者外周血中参与调节针对HBV的免疫反应,CD14+CD16+单核细胞与HBV复制和肝脏炎症之间存在相关性,因此检测单核细胞CD14+CD16+亚群及HLA-DR水平对于了解乙型肝炎患者疾病进程具有重要的临床应用价值。更多还原

【Abstract】 Objective To investigate the mononuclear cell subsets distribution and HLA-DR of the peripheral blood in hepatitis B patients and analysis the relationship among CD14+CD16+monocytes,HLA-DR and the progression of disease. Methods In 50chronic hepatitis B patients,including 21 patients in immune tolerant phase and 29 patients in immune active phase patients,and 31normal controls,the expression levels of CD 14,CD 16,HLA-DR were measured by flow-cytometry. Besides,clinical variables were surveyed for each subjects. Results The expression levels of CD 14,CD16 on monocyte in group of immune active patients showed significant difference as compared to normal control and patients in immune tolerant phase( P < 0. 01). The expression of HLA-DR on monocyte CD14+CD16+subsets proved markedly differences as compared to monocyte CD14+ +CD16-subsets( P < 0. 01). In chronic hepatitis B patients,elevated proportions of circulating CD14+CD16+monocytes were correlated with increased serum ALT levels( r =0. 876,P < 0. 01) and decreased HBV DNA loads( r =- 0. 267,P < 0. 01). Conclusion Monocyte CD14+CD16+subsets may play an active role in immune response to HBV infection. HBV replication or liver inflammation in chronic HBV infection correlates with the monocyte CD14+CD16+subsets. Detection of monocyte CD14+CD16+subsets and HLA-DR provides an important clinical value.更多还原