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目的通过检测血清IL-10和淋巴细胞CD28分子,研究慢性乙型肝炎患者Th细胞分化、抗原呈递过程的异常和免疫损伤的机制。方法依照病例入选标准选择患者1000例和健康对照者500例,采集血清备检,并通过流式细胞仪检测CD28+、CD28+/CD4+、CD28+/CD8+T淋巴细胞构成比。利用IL-10的变化,研究各组间Th1细胞因子表达的差异。结果慢性乙型肝炎病人和急性乙型肝炎病人IL-10水平明显比健康对照组高(P<0.05),但急、慢性乙型肝炎组间无差异(P>0.05)。慢性乙型肝炎患者CD28+、CD28+/CD4+、CD28+/CD8+淋巴细胞所占比例明显比健康对照组高(P<0.05),急性乙型肝炎组水平最高,差异有统计学意义(P<0.01)。结论 IL-10有利于细胞分化,促进细胞免疫反应,是清除病毒所不可缺少的。CD28分子其高水平表达有助于增强机体对病毒的免疫反应,在乙肝病毒清除过程中起重要作用。
Objective To investigate the mechanism of Th cell differentiation, abnormal antigen presentation and immune injury in patients with chronic hepatitis B by detecting serum IL-10 and lymphocyte CD28. Methods 1000 cases of patients and 500 healthy controls were selected according to the criteria of case selection. Serum samples were collected for examination and the proportions of CD28 +, CD28 + / CD4 +, CD28 + / CD8 + T lymphocytes were determined by flow cytometry. Using the changes of IL-10, we studied the differences of Th1 cytokines among groups. Results The levels of IL-10 in patients with chronic hepatitis B and acute hepatitis B were significantly higher than those in healthy controls (P <0.05), but there was no significant difference between acute and chronic hepatitis B patients (P> 0.05). The proportion of CD28 +, CD28 + / CD4 +, CD28 + / CD8 + lymphocytes in patients with chronic hepatitis B was significantly higher than that in healthy controls (P <0.05), and the highest in acute hepatitis B patients (P <0.01). Conclusion IL-10 is conducive to cell differentiation and promote cellular immune response, is indispensable to clear the virus. The high level expression of CD28 molecule helps to enhance the body’s immune response to the virus and plays an important role in the clearance of hepatitis B virus.