目的检测未抗病毒治疗的乙型肝炎肝硬化患者外周血调节性T细胞(Treg细胞)及其亚群频率和血清IL-1β、IL-6、IL-10水平,以探讨乙型肝炎肝硬化患者免疫功能的变化。方法在20例健康对照人群、17例慢性乙型肝炎(CHB)患者和38例乙型肝炎肝硬化(LC)患者,采用流式细胞仪检测外周血CD4+CD25+Foxp3(+Treg)细胞频率、CD4+CD39+Foxp3(+CD39+Treg)细胞和CD4+CTLA-4+Foxp3(+CTLA-4+Treg)细胞频率;采用ELISA法检测血清IL-1β、IL-6和IL-10水平。结果 LC患者Treg细胞频率、CD39+Treg细胞频率、CTLA-4+Treg细胞频率、血清IL-1β、IL-6和IL-10水平均高于正常人(P均〈0.01)和CHB患者(P〈0.05或P〈0.01);失代偿期LC患者Treg细胞频率、CD39+Treg细胞频率、IL-6水平高于代偿期患者(P均〈0.01);LC患者Treg细胞频率与CD39+Treg细胞频率(r=0.474,P〈0.01)、CTLA-4+Treg细胞频率均呈正相关(r=0.330,P〈0.05),Treg细胞频率(r=0.381,P〈0.05)、CD39+Treg细胞频率(r=0.333,P〈0.05)与TBil呈正相关,Treg细胞频率(r=-0.549,P〈0.01)、CD39+Treg细胞频率(r=-0.437,P〈0.01)、CTLA-4+Treg细胞频率(r=-0.368,P〈0.01)与PTA呈负相关,CD39+Treg细胞频率与AST呈正相关(r=0.406,P〈0.05)。结论 Treg细胞及其亚群频率和IL-1β、IL-6、IL-10水平的变化可作为临床初始治疗的乙型肝炎肝硬化患者辅助检查指标之一。
Objective To investigate the frequencies of regulatory T cells (Treg cells),its subgroups and serum levels of IL-113 ,IL-6 and IL-10 in HBV-related liver cirrhosis. Methods In 20 healthy persons,17 patients with chronic hepatitis B (CHB) and 38 with HBV-related liver cirrhosis (LC),the frequencies of CD4+ CD25+Fox3+ cells (Treg cells), CD4+CD39+Fox3+cells (CD39+Treg cells ), and CD4+CTLA-4+ Fox3+cells(CTLA-4+ Treg ceils) were detected by flow cytometry. The serum levels of IL-1 β, IL-6 and IL-10 were detected by ELISA. Results The frequencies of Treg cells,CD39+ Treg cells and CTLA-4+Treg cells and the serum levels of IL-1β , IL-6 and IL-10 in patients with LC were higher than that in normal persons (P〈0.01) and in with CHB (P〈0.05 or P〈0.01);the frequencies of Treg cells,CD39+Treg cells and serum levels of II,-6 in patients with decompensated LC were higher than that in with compensated cirrhosis (P〈0.01); in LC group,the frequencies of Treg cells were positively correlated with CD39 Treg cells (r =0.474,P 〈0.01 )and CTLA -4 +Treg cells (r =0.330,P 〈0.05 );the frequencies of Treg cells(r=0.381,P〈0.05) and CD39+ Treg cells (r=0.333,P〈005) were positively correlated with Tbil. The frequencies of Treg cells(r=-0.549,P〈0.01),CD39+ Treg cells(r=-0.437,P〈0.01) and CTLA-4+Treg(r=- 0.368,P〈0.01) cells were negatively correlated with PTA,and the frequencies of CD39Treg cells were positively correlated with AST(r=0.406,P〈0.05). Conclusion Changes of frequencies of Treg cells, its subgroups and levels of IL-1β ,IL-6,IL-10 can be as a auxiliary examination to give a clinical diagnosis of HBV-related liver cirrhosis who are about to receive initial anti-viral treatment.