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目的探讨病毒性肝炎(乙肝)患者 T 细胞亚群,mIL-2R,sIL-2R,IL-6,IL-8,TNF-α与乙肝发病机制的关系.方法采用 APAAP 技术和 ELISA 法检测92例慢性乙型肝炎患者 T 细胞亚群,mlL-2R 和血清 sIL-2R,IL-6,IL-8,TNF-α水平.结果慢性乙型肝炎患者 CD_4~+细胞数较正常低(P<0.05),对照组和实验组(慢性乙肝轻度、慢性乙肝中重度、肝炎后肝硬变、重症肝炎)的 CD_4~+数值分别为:(45.6±3.6)%,(39.7±10.2)%,(40.6±11.0)%,(39.0±6.5)%,(31.2±8.9)%.CD_8~+细胞数显著上升(P<0.05或 P<0.01),对照组和实验各组依次为:(28.7±3.2)%,(35.4±9.5)%,(38.7±7.6)%,(42.2±9.4)%,以致 CD_4~+/CD_8~+比值下降;mIL-2R 显著低于正常对照组(P<0.05),在 PHA 激活后与正常接近,但均较PHA 激活前显著增高(P<0.01);PHA 激活前的 mIL-2R 对照组与实验组分别为:(15.69±4.32)%,(3.98±5.36)%,(9.37±5.48)%,(9.77±5.76)%,(9.58±5.45)%.PHA 激活后mIL-2R 对照组与实验组分别为:(69.82±5.36)%,(67.98±3.69)%,(69.11±2.19)%,(63.93±1.32)%,(66.32±5.26)%.慢性乙肝患者血清中 sIL-2R,IL-6,IL-8,TNF-α分别为:(798.9±69.0)ng/L,(2806.2±211.7)ng/L,(480.6±32.4)ng/L.正常对照组<100 ng/L,且在慢性肝炎、肝硬变活动期与稳定期之间、重型肝炎的肝坏死与恢复期之间,血清IL-6,IL-8,FNF-α三项指标的差异有显著性,均 P<0.001.结论乙肝患者存在免疫调节紊乱,而免疫异常至少有部分原因是细胞因子的作用.
Objective To investigate the relationship between T cell subsets, mIL-2R, sIL-2R, IL-6, IL-8 and TNF-α and pathogenesis of hepatitis B in patients with viral hepatitis.Methods APAAP and ELISA were used to detect 92 patients The levels of T lymphocyte subsets, mlL-2R, sIL-2R, IL-6, IL-8 and TNF-α in patients with chronic hepatitis B were measured.Results The number of CD_4 ~ + cells in patients with chronic hepatitis B was lower than normal (45.6 ± 3.6)%, (39.7 ± 10.2)% and (39.7 ± 10.2)% respectively in the control group and the experimental group (moderate to severe chronic hepatitis B, severe cirrhosis after hepatitis and severe hepatitis) 40.6 ± 11.0%, 39.0 ± 6.5% and 31.2 ± 8.9%, respectively. The number of CD8 + cells increased significantly (P <0.05 or P <0.01) The percentage of CD_4 ~ + / CD_8 ~ + decreased, the level of mIL-2R was significantly lower than that of the normal control group (P <0.05), (35.4 ± 9.5)%, (38.7 ± 7.6)% and (42.2 ± 9.4) (P <0.01). Before the activation of PHA, the levels of mIL-2R in control group and experimental group were (15.69 ± 4.32)% and (3.98 ± 5.36)%, respectively, , (9.37 ± 5.48)%, (9.77 ± 5.76)% and (9.58 ± 5.45)%, respectively.The levels of mIL-2R in control group and experimental group after PHA activation were (69.82 ± 5.36)% and (67.98 ± 3) (69.11 ± 2.19)%, (63.93 ± 1.32)% and (66.32 ± 5.26)%, respectively.The levels of sIL-2R, IL-6, IL-8 and TNF-α in serum of patients with chronic hepatitis B were L, (2806.2 ± 211.7) ng / L and (480.6 ± 32.4) ng / L, respectively. The normal control group was less than 100 ng / L, and the difference was significant between chronic hepatitis and active cirrhosis and stable period , There was a significant difference between the three indexes of serum IL-6, IL-8 and FNF-αin severe hepatitis with necrosis and convalescence, all P <0.001. Conclusion There are immunomodulatory disorders in patients with hepatitis B, Part of the reason is the role of cytokines.