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目的研究CD4+IL-17A+IFN-γ+T细胞在慢性乙型肝炎患者中的作用及意义。方法采用流式细胞术检测40例慢性HBV感染患者和15例健康志愿者外周血CD4+IL-17A+IFN-γ+T细胞数量,同时采用ELISA法检测血清IL-17A和IFN-γ含量。结果慢性HBV感染重型患者(CSHB)外周血中CD4+IL-17A+IFN-γ+T细胞含量和血清IL-17A含量最高,与慢性HBV感染轻、中度患者(CHB-LM)和慢性HBV感染无症状携带者(AsC)及健康志愿者(HV)比较差异有统计学意义(P均<0.05)。CSHB和CHB-LM患者血清IFN-γ含量均明显低于AsC组和HV组,差异有统计学意义(P均<0.05),AsC组和HV组患者IFN-γ含量差异无统计学意义(P>0.05)。Pearson相关性分析显示,慢性HBV轻、中度患者及慢性HBV重型患者血清IL-17A水平与CD4+IL-17A+IFN-γ+T细胞含量呈正相关(P均<0.05)。慢性HBV无症状携带者,慢性HBV轻、中度患者和慢性HBV重型患者血清IFN-γ含与血清IL-17A含量及外周血CD4+IL-17A+IFN-γ+T细胞含量均无明显相关性(P均>0.05)。结论CD4+IL-17A+IFN-γ+T细胞在慢性乙型病毒性肝炎不同疾病阶段存在差异,可能在HBV发生、发展过程中发挥重要作用。
Objective To study the role and significance of CD4 + IL-17A + IFN-γ + T cells in patients with chronic hepatitis B (CHB). Methods The numbers of CD4 + IL-17A + IFN-γ + T cells in peripheral blood of 40 patients with chronic HBV infection and 15 healthy volunteers were detected by flow cytometry. Meanwhile, the contents of IL-17A and IFN-γ in serum were detected by ELISA. Results The levels of CD4 + IL-17A + IFN-γ + T cells and serum IL-17A in the peripheral blood of patients with chronic HBV infection (CSHB) were the highest and were significantly higher than those of chronic hepatitis B patients with mild to moderate chronic hepatitis B (CHB-LM) Infection with asymptomatic carriers (AsC) and healthy volunteers (HV) was significantly different (P all <0.05). The serum levels of IFN-γ in patients with CSHB and CHB-LM were significantly lower than those in patients with AsC and HV (P <0.05), while those in patients with AsC and HV had no significant difference (P > 0.05). Pearson correlation analysis showed that there was a positive correlation between the level of IL-17A and the level of CD4 + IL-17A + IFN-γ + T cells in patients with chronic HBV, moderate and chronic HBV infection (all P <0.05). Serum levels of IFN-γ in patients with chronic HBV asymptomatic carriers of chronic HBV, moderate and chronic HBV infection were not significantly correlated with serum levels of IL-17A and CD4 + IL-17A + IFN-γ + T cells in peripheral blood (P> 0.05). Conclusion The difference of CD4 + IL-17A + IFN-γ + T cells in different stages of chronic hepatitis B virus may play an important role in the occurrence and development of HBV.