Matveev V A, Savitskiĭ G I, Ketiladze E S
Ter Arkh. 1987;59(7):10-3.
Immunological examination of 158 patients with viral type B hepatitis (VH) was performed over time. Patients with HBsAg elimination for 60 days from the onset of jaundice and a favorable outcome of hepatitis at the height of the process demonstrated a decrease in the relative number of theophylline resistant lymphocytes (T-helpers), a decrease in theophylline sensitive lymphocytes (T-suppressors), an increase in the helper/suppressor (H/S) ratio up to 13.1/1 (the normal ratio being 3.9/1), a certain increase in the number of B-lymphocytes, activation of rosette-forming function of neutrophils, and a tendency to an increase in the activity of natural killer cells (NK). Patients with HBs-antigenemia over 60 days with subsequent convalescence also demonstrated similar changes of immunoregulating T-lymphocyte subpopulations but they developed later in relation to the onset of viral hepatitis. In the formation of chronic persistent hepatitis (CPH) there was no decrease in the absolute and relative number of T-suppressors from the onset of disease, the level of T-helpers and the H/S ratio were moderately lowered. Unlike CPH the suppression of the effector link of the immune system (phagocytosis and NK) and a decrease in the level of T-suppressors were noted in the development of chronic active hepatitis in all the periods of the process. The application of the above regularities to prognosis of VH outcomes, the choice and assessment of efficacy of immunocorrective therapy was discussed.
对158例乙型病毒性肝炎（VH）患者进行了长期的免疫学检查。黄疸出现后60天内乙肝表面抗原（HBsAg）消失且病程高峰期肝炎预后良好的患者，茶碱耐药淋巴细胞（T辅助细胞）相对数量减少，茶碱敏感淋巴细胞（T抑制细胞）减少，辅助/抑制（H/S）比值增至13.1/1（正常比值为3.9/1），B淋巴细胞数量有一定增加，中性粒细胞花环形成功能激活，自然杀伤细胞（NK）活性有增加趋势。乙肝表面抗原血症持续超过60天随后康复的患者也表现出免疫调节性T淋巴细胞亚群的类似变化，但相对于病毒性肝炎发病而言出现较晚。在慢性持续性肝炎（CPH）形成过程中，从疾病发作开始T抑制细胞的绝对数量和相对数量均未减少，T辅助细胞水平和H/S比值适度降低。与CPH不同，在慢性活动性肝炎病程的所有阶段均观察到免疫系统效应环节（吞噬作用和NK）受到抑制以及T抑制细胞水平降低。讨论了将上述规律应用于VH预后判断、免疫纠正治疗的选择及疗效评估。
