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目的进一步明确外周血细胞免疫在ＨＢＶ感染过程中的作用。方法对２０例急性乙型肝炎（乙肝）患者、２３例慢性乙肝患者、２０例正常献血员进行了研究，用氮蓝四唑实验（ＭＴＴ）测定乙肝患者外周血单个核细胞（ＰＢＭＣ）对ＨＢＶ不同区抗原的增殖反应。结果在急性乙肝患者ＰＢＭＣ对抗原的增殖反应大于慢性乙肝患者及正常对照，ＰＢＭＣ对ＨＢｃＡｇ的增殖反应最高，ＨＢｅＡｇ次之，而对ＨＢｓＡｇ的反应均较弱。另外，无论在急性、慢性患者，其ＰＢＭＣ对抗原的增殖反应水平与血清丙氨酸转氨酶（ＡＬＴ）的变化无明显相关性。血清ＨＢＶＤＮＡ阴性、ＨＢｅＡｇ阴性的慢性肝炎或慢性肝炎急性发作患者，其ＰＢＭＣ对ＨＢＶ抗原的增殖反应较弱，在血清ＨＢＶＤＮＡ或ＨＢｅＡｇ阳性患者，增殖反应较强，而当血清ＨＢＶＤＮＡ、ＨＢｅＡｇ均阳性时，增殖反应最强，表明外周细胞免疫与ＨＢＶ的复制及清除相关。结论ＨＢＶ感染后，外周血中存在对ＨＢＶ抗原的细胞免疫，这种细胞免疫可能与乙肝的发病及ＨＢＶ的清除有关。
Objective To further clarify the role of peripheral blood cell immunity in the process of HBV infection. Methods Twenty patients with acute hepatitis B (HBV), 23 patients with chronic hepatitis B and 20 normal blood donors were enrolled in this study. Peripheral blood mononuclear cells (PBMC) Different regions of the antigen proliferation reaction. Results The PBMC proliferative response to antigen in patients with acute hepatitis B was greater than that in patients with chronic hepatitis B and normal controls. PBMC had the highest proliferative response to HBcAg, followed by HBeAg, and had weaker response to HBsAg. In addition, no significant correlation was found between the levels of anti-proliferative responses of PBMC to antigens and the changes of serum alanine aminotransferase (ALT) in both acute and chronic patients. Serum HBVDNA negative, HBeAg-negative chronic hepatitis or acute exacerbation of chronic hepatitis patients, PBMC proliferative response to HBV antigen is weak, strong serum HBVDNA or HBeAg-positive patients, and when the serum HBVDNA, HBeAg were positive, Proliferative response strongest, indicating that peripheral immune and HBV replication and clearance related. Conclusions After HBV infection, there is a cellular immune response to HBV antigens in peripheral blood. This cellular immunity may be related to the pathogenesis of hepatitis B and the clearance of HBV.