慢性乙型肝炎患者谷丙转氨酶水平与乙肝特异性细胞毒性T淋巴细胞及非特异性细胞毒性T淋巴细胞计数的关系

[Relations between ALT level and count of HBV special CTL and non-specific CTL in patients with chronic hepatitis B].

作者信息

Gu Xi-bin, Yang Xiao-juan, Wang Dong, Hua Zhong, Wu Hang-yuan, Xu Yue-qin, Lu Zhong-hua

机构信息

Wuxi Infectious Hospital, Wuzxi 214005, China.

出版信息

Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2009 Oct;23(5):343-5.

PMID:20387481

Abstract

OBJECTIVE

To explore relations between ALT level and hepatitis B virus (HBV) specific CTL and non-specific CTL in patients with chronic hepatitis B (CHB).

METHODS

148 cases of CHB were divided into three groups according to ALT level. 35 cases in group A, ALT > or =2 x upper limit of normal value (ULN)--5 x ULN (100-250 IU/L); 53 cases in group B, ALT > 5 x ULN-- < or =10 x ULN (251-500 IU/L); 60 cases in group C, ALT > 10 x ULN ( > 500 IU/L). Flow cytometry is used to determine non-specific CTV. HBV specific CTL was tested on 74 cases of CHB (17 in group A, 27 in group B and 30 in group C) with positive (HLA)-A2. Compare HBV specific CTL, non-specific CTL, HBV DNA levels and positive rate of HBeAg.

RESULTS

HBV specific CTL: Group A (0.42 +/- 0.10)% is higher than group B (0.25 +/- 0.08)%, t = 6.37, P < 0.01, group B is higher than group C (0.17 +/- 0.004)%, t = 5.14, P < 0.01; Non-specific CTL: Group A (15.01 +/- 3.01)% is lower than group B (18.1 +/- 5.02)%, t = 2.81, P < 0.01, group B is lower than group C (21.5 +/- 6.11)%, t = 3.07, P < 0.01; HBV DNA level: Group A [(4.97 +/- 0.86) log10 copies/ml] is lower than group B [(5.92 +/- 0.92) log10 copies/ml], t = 4.87, P < 0.01. Group B is lower than group C [(6.37 +/- 0.71) log10 copies/ml], t = 2.92, P < 0.01; Positive HBeAg: Group A (15 cases, 42.86%) is lower than group B (32 cases, 60.38%), chi2 = 2.59, P > 0.05. Group B is lower than group C (41 cases, 68.33%), chi2 = 0.78, P > 0.05. Group A is lower than group C, chi2 = 5.929, P < 0.05.

CONCLUSION

The higher the non-specific CTL of patients with CHB is, the higher the ALT level would be, whereas the lower the HBV specific CTL is, the stronger the HBV replication would be.

摘要

目的

探讨慢性乙型肝炎（CHB）患者丙氨酸氨基转移酶（ALT）水平与乙型肝炎病毒（HBV）特异性细胞毒性T淋巴细胞（CTL）及非特异性CTL之间的关系。

方法

148例CHB患者按ALT水平分为三组。A组35例，ALT≥2倍正常上限值（ULN）且≤5倍ULN（100 - 250 IU/L）；B组53例，ALT＞5倍ULN且≤10倍ULN（251 - 500 IU/L）；C组60例，ALT＞10倍ULN（＞500 IU/L）。采用流式细胞术检测非特异性CTL。对74例CHB患者（A组17例、B组27例、C组30例）进行（人白细胞抗原）HLA - A2阳性的HBV特异性CTL检测。比较HBV特异性CTL、非特异性CTL、HBV DNA水平及HBeAg阳性率。

结果

HBV特异性CTL：A组（0.42±0.10）%高于B组（0.25±0.08）%，t = 6.37，P＜0.01；B组高于C组（0.17±0.004）%，t = 5.14，P＜0.01。非特异性CTL：A组（15.01±3.01）%低于B组（18.1±5.02）%，t = 2.81，P＜0.01；B组低于C组（21.5±6.11）%，t = 3.07，P＜0.01。HBV DNA水平：A组[（4.97±0.86）log10拷贝/ml]低于B组[（5.92±0.92）log10拷贝/ml]，t = 4.87，P＜0.01；B组低于C组[（6.37±0.71）log10拷贝/ml]，t = 2.92，P＜0.01。HBeAg阳性：A组（15例，42.86%）低于B组（32例，60.38%），χ² = 2.59，P＞0.05；B组低于C组（41例，68.33%），χ² = 0.78，P＞0.05；A组低于C组，χ² = 5.929，P＜0.05。