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目的探讨慢性乙型肝炎患者外周血髓系抑制性细胞(myeloid-derived suppressor cells,MDSCs)在疾病进展中的临床意义。方法选取在广州市第八人民医院接受抗病毒治疗的慢性乙型肝炎患者16例及19例健康对照者,用流式细胞术检测外周血单核细胞(PBMC)中MDSCs的比例,并动态检测该比例在核苷(酸)类似物(NAs)抗病毒治疗12周、24周后的变化特征,用Spearman相关法分析MDSCs比例与血清HBV DNA载量、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和总胆红素(TBIL)等指标之间的相关性。统计分析采用均数t检验,MDSCs水平采用单因素方差分析检验,P<0.05为差异有统计学意义。结果慢性乙型肝炎患者外周血MDSCs表型为HLADR-/lowCD11b+CD33+的细胞群其主要为CD14+的单核细胞型。其比例为(1.4±0.27)%,明显高于健康对照组(0.53±0.06)%,(P<0.01);抗病毒治疗12周后其比例为(1.33±0.26)%、24周后其比例为(1.82±0.48)%。MDSCs的比例与治疗前比较差异无统计学意义(P=0.778,P=0.452)。横断面比较分析结果显示MDSCs水平与HBV DNA无相关性(r=-0.14,P=0.60),但与ALT(r=0.621,P=0.01)、AST(r=0.612,P=0.012)、TBIL(r=0.717,P=0.003)呈显著正相关。结论慢性乙型肝炎患者外周血MDSCs比例在一定程度上反映慢性乙型肝炎病情。
Objective To investigate the clinical significance of myeloid-derived suppressor cells (MDSCs) in the progression of chronic hepatitis B patients. Methods Sixteen patients with chronic hepatitis B and 19 healthy controls who were treated with antiviral therapy in Eighth People ’s Hospital of Guangzhou were enrolled. The proportion of MDSCs in peripheral blood mononuclear cells (PBMCs) was detected by flow cytometry and detected dynamically The ratio of MDSCs to serum HBV DNA load, alanine aminotransferase (ALT), serum alanine aminotransferase Aspartate aminotransferase (AST) and total bilirubin (TBIL) and other indicators of the correlation between. Statistical analysis using mean t test, MDSCs level by one-way analysis of variance test, P <0.05 for the difference was statistically significant. Results The majority of MDSCs phenotype in patients with chronic hepatitis B were HLADR- / lowCD11b + CD33 + cells, which were predominantly CD14 + monocytes. The proportion was (1.4 ± 0.27)%, significantly higher than that of the healthy control group (0.53 ± 0.06)%, (P <0.01). After 12 weeks of antiviral therapy, the proportion was (1.33 ± 0.26)%, (1.82 ± 0.48)%. There was no significant difference in the proportion of MDSCs between before and after treatment (P = 0.778, P = 0.452). The results of cross-sectional analysis showed that there was no correlation between the level of MDSCs and HBV DNA (r = -0.14, P = 0.60), but not with the level of ALT (r = 0.621, (r = 0.717, P = 0.003) showed a significant positive correlation. Conclusion The proportion of MDSCs in peripheral blood of patients with chronic hepatitis B reflects the severity of chronic hepatitis B to some extent.