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目的 该实验旨在研究慢性丙型肝炎病人周围血和肝内淋巴细胞各亚群变化与丙型肝炎病毒血症、肝脏组织病变活动指数等之间的关系。方法 采用流式细胞仪三色荧光标记单克隆抗体技术对慢性丙型肝炎病人和正常对照的周围血和肝内淋巴细胞各亚群进行了测定,同时应用逆转录—多聚酶链反应技术对丙型肝炎病毒血清浓度进行检测并进行了肝组织活检确定肝脏组织病变活动程度。结果 发现慢性丙型肝炎病人肝内CD4~+辅助淋巴细胞比例数显著高于正常对照(20.7±7.3％对10.2±4.6％,p=0.027),并与肝脏组织病变活动指数(Knodell score)呈显著正相关(r=0.48,p=0.004)。周围血淋巴细胞和肝内淋巴细胞亚群堤活性变化有很大不同,但该实验未发现周围血淋巴细胞与病变程度有任何相关。结论 提示机体的免疫反应特别是肝内的区域免疫反应的确在引起肝脏组织细胞损伤的过程中起重要作用,活性CD4~+辅助淋巴细胞可能通过正性调节CD8~+细胞毒性淋巴细胞在肝内造成肝脏组织细胞损伤。
Objective The purpose of this study was to investigate the relationship between changes in peripheral blood and intrahepatic lymphocytes in patients with chronic hepatitis C and hepatitis C viremia and liver tissue activity index. Methods The peripheral blood and intrahepatic lymphocyte subsets of patients with chronic hepatitis C and normal controls were determined by flow cytometry with three-color fluorescence-labeled monoclonal antibody. The reverse transcription-polymerase chain reaction Hepatitis B virus serum concentrations were examined and liver biopsy was performed to determine the extent of liver tissue lesion activity. The results showed that the proportion of CD4 ~ + helper lymphocytes in the liver of patients with chronic hepatitis C was significantly higher than that of the control (20.7 ± 7.3% vs 10.2 ± 4.6%, p = 0.027), and was positively correlated with the liver tissue lesion activity index (Knodell score) Significantly positive correlation (r = 0.48, p = 0.004). Peripheral blood lymphocytes and intrahepatic lymphocyte subsegments vary greatly in diagetic activity, but the experiment did not find any correlation between peripheral blood lymphocytes and the degree of lesion. Conclusions It is suggested that the immune response in the body, especially the intrahepatic regional immune response, plays an important role in the process of liver cell injury. The active CD4 ~ + helper lymphocytes may regulate the CD8 ~ + cytotoxic lymphocytes in the liver Cause liver tissue damage.