聚乙二醇化干扰素α-2a对慢性乙型肝炎患者外周血T淋巴细胞亚群的影响

摘要

Objective To study the change of peripheral T lymphocyte subsets and its impacton patients with chronic hepatitis B(CHB) during peginterferon-alph2a treatment. Methods Fifty-two patients with chronic hepatitis B were recruited and received peginterferon-alph2a treatment for 48 weeks. Before and during the 12 and 48 weeks of treatment, flow cytometry was used to detect the Peripheral T lymphocyte subsets. Realtime PCR was used to detect the level of HBV DNA. Markers of hepatitis B virus infection were detected by ELISA assay and level of alanine aminotransferase in the serum was measured by automatic biochemical analyzer. Results The proportion of peripheral blood CD4 +、D4+/ CD8 + in patients with CHB was significantly lower than that in healthy people( P <0. 05) and the proportion of peripheral blood CD8+T lymphocytes are increasing (P <0. 05). During 12 weeks of INFa treatment the proportion of peripheral blood CD4+ T lymphocytes and the ratio of CD4 + / CD8+ increased gradually, the proportion of peripheral blood CD8+ T lymphocytes decreased to normal level after 48 weeks INFa treatment. Treatment for 12 and 48 weeks with INFa resulted in HBeAg seroconversion to negative in 44. 2% patients and 51.9% patients respectively. In 11 (21. 1% ) patients who had seroconvertion from HBeAg to anti-HBeAg, after 12 months of INFa treatment, their proportion of peripheral blood CD4+、CD4+ / CD8+ had increased to level similar to that of the healthy people. Conclusions INFa treatment reduces HBV replication and increases the proportion of peripheral blood GD4+、CD4 + / CD8+ and these patients are prone to have higher sustain virus response and higher biochemical response.%目的 动态观察慢性乙型肝炎患者(CHB)聚乙二醇化干扰素α-2a治疗过程中外周血T淋巴细胞亚群的变化及其临床意义.方法 给予52例CHB患者聚乙二醇化干扰素α-2a (PEG-IFNa-2a)抗病毒治疗48周.在治疗前、治疗12和48周,分别以流式细胞术检测外周血淋巴细胞亚群百分比和数量,全自动生化分析仪检测谷丙转氨酶(ALT)水平,荧光定量PCR检测血清HBV DNA水平,酶联免疫吸附法检测HBV标志物.结果52例CHB患者CD4+、CD4+/CD8+比值均下降(P＜0.05),CD8+T升高(P＜0.05).PEG-IFNα-2a抗病毒治疗过程中,患者外周血CD4+T、CD4+/CD8+比值明显升高(P＜0.05),CD8+T值下降(P＜0.01),48周时基本恢复至正常水平.治疗12和48周时,HBeAg阴转率分别为44.2%和51.9%,其中11例(21.1%)发生血清学转换者在治疗12周时CD4+、CD4+/CD8+比值均已恢复至正常人水平.结论 PEG-IFNα-2a治疗慢性乙型肝炎致患者CD4+、CD4+/CD8+比值升高可获得持续性病毒学及生化学应答的概率高,抗病毒效果好.