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目的研究聚乙二醇干扰素(PEG-IFN)治疗慢性丙型肝炎(CHC)患者T细胞亚群及其表面程序性死亡受体-1(PD-1)的表达、B细胞的变化。方法从接受PEG-IFNα-2a抗病毒治疗的CHC患者中选择快速病毒学应答者(RVR)20例、无应答者(NR)20例,采用流式细胞仪分别检测其治疗前及治疗12周时外周血T细胞亚群及其表面PD-1的表达、B细胞的表达水平,并以20名健康体检者作为正常对照组,分析其表达水平差异及临床意义。结果 CHC患者治疗前与正常对照组比较,CD4+T细胞增高,CD4+T/CD8+T增高,CD19+B细胞增高,CD8+T细胞降低,T细胞亚群(CD4+/CD8+)表面PD-1的表达明显升高,差异均有统计学意义(P<0.01)。治疗12周时NR组与RVR组比较,CD4+T细胞增高,CD4+T/CD8+T增高,CD19+B细胞增高,CD8+T细胞降低,T细胞亚群CD4+/CD8+上表达的PD-1升高,差异均有统计学意义(P<0.05)。结论 CHC患者T细胞亚群失衡及B淋巴细胞升高,经PEG-IFN治疗后,其免疫功能得到一定恢复。PD-1的高表达与丙肝病毒复制有关,可能是导致T淋巴细胞应答能力下降的重要原因。
Objective To investigate the changes of T cell subsets and the expression of PD-1 and B cells in patients with chronic hepatitis C (CHC) treated with pegylated interferon (PEG-IFN). Methods Twenty patients with rapid virological response (RVR) and 20 non-responders (NR) were selected from CHC patients receiving PEG-IFNα-2a antiviral therapy. Before and 12 weeks after treatment, The expression of PD-1 and the expression of B-cell in peripheral T lymphocyte subsets and their peripheral blood were detected. Twenty healthy controls were used as normal control group to analyze their differences in expression level and clinical significance. Results The levels of CD4 + T cells, CD4 + T / CD8 + T, CD19 + B cells and CD8 + T cells in CHC patients before treatment were significantly higher than those in normal controls 1 expression was significantly increased, the difference was statistically significant (P <0.01). Compared with RVR group, the number of CD4 + T cells increased, CD4 + T / CD8 + T increased, CD19 + B cells increased, CD8 + T cells decreased and the expression of PD- 1 increased, the differences were statistically significant (P <0.05). Conclusions The imbalance of T lymphocyte subsets and B lymphocytes in CHC patients may result in the recovery of immune function after treatment with PEG-IFN. The high expression of PD-1 is associated with hepatitis C virus replication, which may be an important reason for the decrease of T lymphocyte response ability.