慢性 HBV感染者外周血 Treg 水平与HBV－DNA载量的相关性研究

摘要

目的：探讨慢性HBV感染者外周血CD4＋CD25＋调节性T细胞（ Treg ）水平与HBV－DNA载量的相关性。方法选取2013年1月—2014年12月石河子大学医学院第一附属医院感染科收治的住院和门诊慢性 HBV感染者100例，其中轻中度慢性乙型肝炎（CHBLM）组43例、乙型肝炎肝硬化（LC）组27例、慢性重型乙型肝炎（CSHB）组30例；选取同期该院健康体检者36例为健康对照（ HC）组。采用实时荧光定量聚合酶链反应法（ FQ－PCR）检测HBV－DNA载量，采用流式细胞仪检测Treg水平。外周血Treg水平与HBV－DNA载量的相关性采用Pearson相关分析。结果 CHBLM、 LC、 CSHB 组的HBV－DNA载量比较，差异有统计学意义（ F＝4.564， P＜0.05）；两两比较显示， CHBLM组与LC组间差异有统计学意义（ P＜0.05），其他组间差异无统计学意义（ P＞0.05）。 CHBLM、 LC、 CSHB、HC组的Treg水平比较，差异有统计学意义（ F＝25.218， P＜0.05）；组间两两比较显示，组间差异均有统计学意义（P＜0.05）。 CHBLM、 LC、 CSHB组外周血Treg水平与HBV－DNA载量均呈正相关（r值分别为0.458、0.697、0.544， P＜0.05）。结论慢性HBV感染者Treg水平增加， Treg水平与HBV－DNA载量呈正相关。提示Treg在慢性HBV感染中担负着重要的免疫调节作用，可能抑制HBV感染者特异性细胞免疫反应，与HBV感染的慢性化及肝病的临床发生、发展有关。%Objective To explore the correlation between CD 4 +CD25 +regulatory T cell ( Treg) level in the peripheral blood and HBV-DNA load of patients with hepatitis B virus infection.Methods We enrolled 100 HBV inpatients and outpatients in the First Affiliated Hospital of the Medical College of Shihezi University between January 2013 to December 2014.Among the subjects, 43 were assigned into light -medium chronic hepatitis B ( CHBLM) group, 27 were assigned into hepatitis B liver cirrhosis (LC) group, and 30 were assigned into severe chronic hepatitis B (CSHB) group.We also enrolled 36 healthy people who received physical examination in the hospital in the same period as health control ( HC) group.FQ-PCR was used to examine HBV-DNA load, and flow cytometry was used to test Treg level.Pearson correlation analysis was conducted to investigate the correlation between Treg level and HBV-DNA load.Results There were significant differences among the three groups in HBV-DNA load (F=4.564, P<0.05); in pairwise comparison, significant difference existed between CHBLM group and LC group ( P <0.05 ) , while no significant differences existed between other two groups.The four groups were significantly different in Treg level (F=25.218, P<0.05); in pairwise comparison, significant differences existed between any two groups ( P<0.05 ) .In CHBLM group , LC group and CSHB group , there was positive correlation between Treg level and HBV-DNA load (r values were 0.458, 0.697 and 0.544 respectively, P<0.05) .Conclusion Patients with chronic hepatitis B virus infection have higher Treg level , and there is positive correlation between Treg level and HBV-DNA load.Treg has important immunomodulatory effects on chronic hepatitis B virus infection and may inhibit the specific cellular immune response , and it is related with the chronicity of HBV infection and the clinical application and development of liver diseases .