扁平疣患者的HPV型别、性激素水平、人体免疫状况探讨

摘要

Objective:Testing the human papillomavirus(HPV) genotypes,sex hormone levels(estradiol,progesterone,testosterone,prolactin),immune state(CD4+、CD8+、Th17 cell) in patients with flat warts,to discover their effect on the pathogenesis.Method:Thirty women with clinically diagnosed flat warts admitted to our hospital from March 2012 to August 2012 were selected as the flat warts group,and 30 healthy adult women were selected as the control group.The HPV types of patients with flat warts were distinguished by polymerase chain reaction(PCR) and RT-PCR,the sex hormone levels of the two groups were detected by radio immunoassay,and the immune state(CD4+、CD8+、Th17 cell) of the two groups were distinguished by flew cytometry(FCW).Result:The most common HPV genotype of patients in flat warts group was HPV2,the infection rate was 28%,and HPV3,HPV10,HPV1 were in turn. The difference between patients with flat warts and the healthy adult women had no statistically significant on sex hormone levels(P>0.05).Peripheral blood CD4+,CD8+,Th17 T lymphocyte subsets in patients with flat wart were decreased compared with normal persons,the difference was statistically significant between the two groups(P<0.05). Conclusion:The patients with flat warts had no statistically significant with the normal on sex hormone levels,but with low cell immune functions.%目的：检测扁平疣患者感染HPV的类型、外周血中免疫活性细胞(CD4+、CD8+、Th17细胞)及性激素(雌二醇、孕酮、睾酮、泌乳素)的表达水平，探讨其在扁平疣发病机制中的作用。方法：选择2012年3-8月于笔者所在医院皮肤科门诊就诊的扁平疣女患者30例为研究对象，设为扁平疣组，同期选取与扁平疣组年龄相当的30例健康成年女性为正常对照组。用PCR与RT-PCR方法检测扁平疣组患者病损表皮中HPV的类型；采用放射免疫分析法检测两组受试者血清雌二醇、孕酮、睾酮、泌乳素的表达水平；用流式细胞术检测外周血的免疫活性细胞(CD4+、CD8+、Th17细胞)水平，观察比较两组检测结果。结果：扁平疣患者HPV型别以HPV2最为常见，感染率为28%，其他依次为HPV3、HPV10、HPV1。两组间性激素水平比较差异无统计学意义(P>0.05)。扁平疣患者外周血CD4+、CD8+、Th17 T淋巴细胞亚群均较正常人下降，两组比较差异均有统计学意义(P<0.05)。结论：扁平疣患者的性激素水平与正常成年人比较，差异无统计学意义，但扁平疣患者存在细胞免疫功能低下。