Objective To study the relationship between the expressions of CD4+ T protein,the serum activinA(ACTA), tumour necrosis factor-α(TNF-α) and the inflammatory reaction, and the pathological changes of the liver tissue in patients with chronic hepatitis. Methods The expression of CD4 + T protein was analyzed by flow cytometry and the serum ACTA, TNF-α content were assayed by Elisa in 128 cases of chronic hepatitis B. And liver biopsy, inflammation classification and fibrosis stage division were carried out at the same time, then the relationship between these indexes above and the pathological changes of the liver tissue were analysed. Results The expresion of CD4 + T protein increased along with the illness progressing. But the change of Bcl-2 protein was not obvious. And the level of the serum ACTA and TNF-α in patients with chronic hepatitis B was consistent with its development stages, which reached the highest level at the severe stage of chronic hepatitis B and in liver cirrhosis. They were also consistent with the levels of liver tissue inflammation and fibrosis, manifesting the highest level in inflammation fobrosis stage S4. Conclusion The expression of CD4 +T protein, and serum ACTA, TNF-α were closely correlated to the pathogenesis of the hepahepatic fibrosis. The above indexes had some theoretic and clinical significance in the dynamic observation of liver fibrosis, the early diagnosis, the therapy, and the estimate of the prognosis.%目的 研究慢性乙肝(CHB)患者外周血CD4+T细胞凋亡信号蛋白的表 达情况,激活素A(ACTA)、肿瘤坏死因子-α(TNF-α)含量与肝组织炎症活动及纤维化程度 的关系.方法 应用流式细胞术分析128例慢性乙肝患者外周血CD4+ T细胞凋亡信号蛋白FasL和Bcl-2表达情况,采用酶联免疫吸附试验(ELISA)测定血清ACTA、 TNF-α含量,同时进行肝组织活检,对肝组织进行炎症分级及纤维化分期,分析以上指标 与肝组织病理变化的关系.结果 慢性乙肝患者FasL蛋白表达随病情发 展增加很明显,Bcl-2变化相对不是很显著.而血清ACTA、TNF-α含量与慢性乙肝发展阶 段性相一致,在慢性乙肝重度与肝硬化(LC)阶段达最高水平;该结果与肝组织炎症及纤维化 程度一致,在纤维化分期S4处于最高水平.结论 CD4+T细胞凋亡信 号蛋白FasL表达、血清ACTA、TNF-α与肝纤维化的发病机制密切相关,检测这些指标对于 肝纤维化动态观察、早期诊断及预后评估具有一定的理论和临床价值.
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