【摘要】 目的探讨不同血清病毒载量的慢性丙型肝炎(CHC)患者外周血滤泡辅助性T淋巴细胞(Tfh)表面程序性死亡受体-1(PD-1)表达情况。方法根据血清HCV RNA水平不同,将180例CHC患者分为低病毒载量组76例,3 lg copies/ml≤血清HCV RNA <6 lg copies/ml和高病毒载量组104例,血清HCV RNA≥6 lgcopies/ml。比较两组外周血Tfh细胞百分比、Tfh细胞表面PD-1阳性率、外周血T、B淋巴细胞亚群、外周血CD4~+T淋巴细胞和CD8~+T淋巴细胞表面PD-1表达和血清白细胞介素21(IL-21)水平的差异。结果低病毒载量组和高病毒载量组血清HCV RNA水平分别为(4.5±1.2)lg copies/ml和(6.4±0.7)lg copies/ml,Tfh细胞表面PD-1阳性百分比分别为(26.2±2.2)%和(37.2±1.1)%,Tfh细胞百分比分别为(7.9±0.7)%和(5.1±0.4)%,血清IL-21水平分别为(46.8±1.3) ng/L和(21.7±1.1) ng/L,差异均有统计学意义(P<0.01);低病毒载量组和高病毒载量组外周血CD4~+T细胞百分比分别为(51.1±4.6)%和(37.6±4.4)%,CD8~+T细胞百分比分别为(24.0±3.1)%和(31.7±3.9)%,CD4~+T/CD8~+T细胞比值分别为(3.3±0.2)和(2.3±0.1),CD19~+B细胞百分比分别为(16.7±3.9)%和(11.8±3.2)%,差异具有统计学意义(P<0.01);低病毒载量组和高病毒载量组外周血CD4~+T细胞表面PD-1阳性率分别为(10.1±2.3)%和(2.4±0.6)%],CD8~+T细胞表面PD-1阳性率分别为(6.3±2.2)%和(1.0±0.3)%,差异也具有统计学意义(P<0.01)。结论不同血清病毒载量的CHC患者外周血Tfh和T淋巴细胞亚群以及血清白细胞介素21水平存在显著差异,进一步探讨它们对病情、抗病毒治疗应答和预后的关系,将具有十分重要的临床意义。更多还原

【Abstract】 Objective To compare the difference of programmed cell death receptor-1(PD-1) receptor on peripheral blood follicular helper T lymphocyte(Tfh) surface in chronic hepatitis C(CHC) patients with low and high serum viral loads. Methods 180 patients with CHC were divided into two group,and 76 had serum HCV RNA level of less than 6 lg copies/ml and 104 had serum HCV RNA level of greater than 6 lg copies/ml. The percentage of PD-1 on peripheral blood Tfh cell surface,percentage of Tfh,peripheral blood T and B lymphocyte subsets and serum interleukin 21(IL-21) level were detected. Results In patients with low and high viral load groups,serum HCV RNA levels were(4.5±1.2) lg copies/ml and(6.4±0.7) lg copies/ml,the percentages of PD-1 on Tfh cell surface were(26.2±2.2)% and(37.2±1.1)%,the percentages of Tfh cells were(7.9±0.7)% and(5.1±0.4)%,and serum IL-21 levels were(46.8±1.3) ng/l and(21.7±1.1) ng/l,all significantly different between the two groups(P<0.05);the percentages of CD4~+T lymphocyte were(51.1±4.6)% and(37.6±4.4)%],the percentages of CD8~+T cell were(24.0±3.1)% and(31.7±3.9)%],the ratios of CD4~+T/CD8~+T cells were(3.3±0.2) and(2.3±0.1)],the percentage of CD19~+B cell were(16.7±3.9)%and(11.8±3.2)%,all significantly different between the two groups(P<0.05);the percentages of PD-1 on CD4~+T lymphocyte surface were(10.1 ±2.3)% and(2.4 ±0.6)% ],and the percentages of PD-1 on CD8 ~+T cell surface were(6.3±2.2)% and(1.0±0.3)%(both P<0.01). Conclusion There were significant differences between patients with low and high serum HCV RNA loads as respect to their peripheral blood Tfh and PD-1 expression,which might be important in evaluating the response to antiviral therapy and prognosis.更多还原