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目的:探讨慢性乙型肝炎患者外周血CD4+T细胞免疫效应蛋白和炎症因子的表达情况,并分析其与感染状态的相关性。方法:根据感染状态患者分为肝功能正常高病毒复制组、肝功能正常低病毒复制组、肝功能异常高病毒复制组、肝功能异常低病毒复制组。应用流式细胞术检测外周血CD4+T细胞表达的免疫效应蛋白和炎症因子水平,并分析上述指标与感染状态的相关性。结果:肝功能正常/异常的高病毒组的CD4+T细胞分泌的TNF-α明显高于正常对照组(P<0.05);肝功能异常高病毒组CD4+T细胞分泌的IFN-γ明显低于肝功能正常高/低病毒组和正常对照组(P<0.05);而各组CD4+T细胞分泌的穿孔素(PF)、颗粒酶B(GrB)、颗粒溶素(GNLY)相比无明显差异;CD4+T细胞表达的GrB、IFN-γ、GNLY两两相比呈正相关,PF和GrB呈正相关。结论:慢性乙型肝炎患者外周血CD4+T细胞表达的免疫效应蛋白与感染性无关,但表达的炎症因子TNF-α与病毒复制呈正相关,IFN-γ与肝脏损害呈负相关。
Objective: To investigate the expression of CD4 + T cell immunoreactive effector protein and inflammatory cytokines in peripheral blood of patients with chronic hepatitis B and to analyze their correlation with infection status. Methods: According to the infected patients, the patients were divided into normal high-virus replication group, normal low-virus replication group, high-virus replication group and low-virus replication group. The levels of immune effector protein and inflammatory cytokines expressed in peripheral blood CD4 + T cells were detected by flow cytometry, and the correlations between the above indexes and infection status were analyzed. Results: The levels of TNF-α secreted by CD4 + T cells in normal and abnormal high-virus group were significantly higher than those in normal control group (P <0.05). The IFN-γ secreted by CD4 + T cells in high-dysfunction group was significantly lower (P <0.05), while the levels of perforin (PF), granzyme B (GrB) and granule lysin (GNLY) secreted by CD4 + T cells in each group were significantly lower than those in normal liver / Significant difference; CD4 + T cells expressed GrB, IFN-γ, GNLY two two was positively correlated, PF and GrB was positively correlated. Conclusion: The expression of immune effector protein in peripheral blood CD4 + T cells in patients with chronic hepatitis B is not related to infectiousness, but the expression of TNF-α is positively correlated with viral replication, and IFN-γ is negatively correlated with liver damage.