目的：探讨慢性HBV感染者不同免疫状态与乙肝肝硬化患者外周血T、B细胞亚群和NK细胞的变化。方法：收集慢性HBV感染者75例，其中免疫清除状态20例、免疫不全状态（非活动期）20例、肝硬化35例（代偿期17例、失代偿期18例），正常对照组20例。采用流式细胞仪检测其外周血T、B细胞亚群和NK细胞百分比，并分析各组之间的差异。结果：各组CD4＋T细胞均低于对照组（P＜0．05），由高到低顺序为对照组、免疫不全组、免疫清除组、代偿期肝硬化、失代偿期肝硬化。免疫清除组的CD4＋／CD8＋、NK细胞低于对照组，CD8＋T细胞、B细胞高于对照组（P＜0．05）。免疫不全组的CD4＋／CD8＋低于对照组，CD8＋T细胞高于对照组（P＜0．05）。失代偿期肝硬化的CD4＋／CD8＋、B细胞高于其他各组，CD3＋T细胞、CD8＋T细胞和NK细胞低于其他各组（P＜0．05）。结论：慢性HBV感染者体内存在免疫功能紊乱，外周血淋巴细胞亚群和NK细胞检测对于了解患者免疫状态、疾病进展有一定的临床价值。%Objective To explore the percentage changes of peripheral T , B cell subsets and NK cells in chronic HBV infectors under different immune states and hepatitis B cirrhosis . Methods Seventy-five chronic HBV infectors, including 20 cases with immune clearance, 20 cases with immunodeficiency (inactive) and 35 cases with cirrhosis, and 20 healthy control were enrolled. The percentages of peripheral T and B lymphocyte subsets and NK cells were detected by Flow Cytometry. The differences of the groups were analyzed. Results Comparing with the control group, CD4+T cells were decreased in the other four groups (P<0.05). The sequence of CD4+T cells, from high to low, was the control group, the immunodeficiency group, the immune clearance group, the compensated cirrhosis group and the de-compensated cirrhosis group. CD4+/CD8+T cell and NK cell were lower , but CD8+T cell and B cell were higher in immune clearance group than that of the control group (P < 0.05). Patients in immunodeficiency group had lower ratio of CD4+/CD8+T cell and higher CD8+T cell than those in the control group (P < 0.05). In all the groups, patients with de-compensated cirrhosis showed highest ratio of CD4+ to CD8+ T cells and B cells, but lowest CD3+T, CD8+ T and NK cells (P < 0.05). Conclusions Results suggests immune dysfunction exists in patients with chronic HBV infection. It has potential clinical value in understanding patients′ immune states and progression of disease by detecting peripheral blood lymphocyte subsets and NK cells.
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