目的 · 研究慢性乙型肝炎病毒(HBV)感染患者外周血自然杀伤(NK)细胞和树突状细胞(DC)比例与肝损伤的关系。 方法 · 采集65 例不同类型慢性HBV 感染患者和10 例健康志愿者(HCs 组)外周血,流式细胞术检测NK 细胞及DC 比例。根据患 者 HBV 血清学指标包括丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TB)、直接胆红素(DB) 水平,将65 例患者分为无症 状 HBV 携带者(AsCs)组(n=7)、慢性乙型肝炎轻- 中度(CHB-LM)组(n=38)、慢性乙型肝炎重度(CSHB)组(n=20), 进行组 间比较,并分析NK 细胞、DC 及两者比例与肝损伤的关系。结果 · 组间比较外周血NK 细胞比例,CHB-LM 组[( 9.29±1.20) %]和 CSHB 组[( 3.60±0.79) %]低于HCs 组[( 14.77±2.90) %]和AsCs 组[( 14.05±2.32) %](均 P=0.000)。外周血DC 比较,CHB-LM 组 [( 4.10±1.18) %]高于HCs 组[( 1.67±0.31) %]、 AsCs 组[( 2.05±0.46) %]和CSHB 组[( 2.08±0.41) %]( P=0.000)。 NK/DC 比值比 较,CHB-LM 组(2.77±1.67)和CSHB 组(2.24±2.08)明显低于HCs 组(10.11±4.24)和AsCs 组(8.12±5.05)(均 P=0.000)。相关性 分析结果显示慢性 HBV 感染者 NK 细胞比例与 ALT、AST、TB、DB 水平呈负相关(r=-0.50,r=-0.49,r=-0.53,r=-0.51,均 P=0.000)。 结论 · 慢性乙型肝炎患者外周 NK 细胞比例和 NK/DC 比值降低,慢性 HBV 感染者外周 NK 细胞比例和 NK/DC 比值下降与肝损伤相关。
Objective · To investigate the correlation between proportion of natural killer (NK) cells and dendritic cells (DCs) and liver injury in patients with chronic hepatitis B virus (HBV) infection. Methods · Peripheral blood samples were collected from 65 patients with chronic HBV infection and 10 healthy volunteers (HCs group). Flow cytometry was used to detect the proportion of peripheral NK cells and DCs. The patient were divided into asymptomatic HBV carrier (AsCs) group, chronic hepatitis B in low or moderate grade (CHB-LM) group, and chronic severe hepatitis B (CSHB)group. The relationship of the proportion of NK cells, the proportion of DCs, and the ratio of NK/DC with the degree of liver injury was analyzed. Results · The proportion of peripheral NK cells was significantly lower in CHB-LM group (9.29%±1.20%) and CSHB group (3.60%±0.79%) than that in HCs group (14.77%±2.90%) and AsCs group (14.05%±2.32%) (P=0.000). And the proportion of peripheral DCs was significantly higher in CHB-LM group (4.10%±1.18%) than that in HCs (1.67%±0.31%), AsCs (2.05%±0.46%) and CSHB groups (2.08%±0.41%) (P=0.000). The ratio of NK/DC was decreased in CSHB and CHB-LM groups compared to that in HCs and AsCs groups (P=0.000). The correlation analysis indicated the proportion of NK cells was negatively correlated with the levels of ALT, AST, TB and DB (r=-0.50, r=-0.49, r=-0.53, r=-0.51, P=0.000 for all) in patients with chronic HBV infection. Conclusion · The proportion of peripheral NK cells and the ratio of NK/DC in patients with chronic hepatitis B were decreased. The decrease of the frequency of NK cells and the ratio of NK/DC were associated with liver injury in patients with chronic HBV infection.