慢性丙型肝炎患者外周血CD4+调节性T淋巴细胞水平的变化及其与抗病毒疗效的关系

郭飞波

doi:10.3969/j.issn.1001-5256.2016.12.017

慢性丙型肝炎患者外周血CD4+调节性T淋巴细胞水平的变化及其与抗病毒疗效的关系

DOI: 10.3969/j.issn.1001-5256.2016.12.017

郭飞波

湖北省天门市第一人民医院检验科

详细信息

中图分类号: R512.63;R446.6
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出版历程
- 出版日期: 2016-12-20

Change in peripheral blood CD4~+ regulatory T cells and its association with antiviral effect in patients with chronic hepatitis C

Guo FeiBo

摘要

摘要: 目的探讨慢性丙型肝炎（CHC）患者的外周血CD4+调节性T淋巴细胞（Treg）的变化及其与抗病毒疗效间的关系。方法收集2013年1月-2016年1月于本院完成标准化抗病毒治疗与随访的85例CHC患者作为CHC组,选取40例同期健康志愿者为对照组。于治疗前,治疗12、48周,以及随访24周时采用流式细胞测定患者的外周血CD4+Treg,并测定血清HCV RNA、AST、ALT水平。计量资料组间比较采用t检验。结果治疗前,CHC组的HCV RNA、AST、ALT及CD4+Treg水平均显著高于对照组,差异有统计学意义（P值均<0.001）。治疗12周时,CHC组85例患者中36例（42.35%）获得早期病毒学应答（EVR）（EVR组）,另49例（57.65%）未获得EVR（no-EVR组）,EVR组患者的HCV RNA和CD4+Treg水平较治疗前均显著降低（t分别为39.241、8.763,P值均<0.001）,2组间HCV RNA、CD4+Treg水平比较差异有统计...
- 肝炎,丙型,慢性 /
- T淋巴细胞,调节性 /
- 治疗结果
Abstract: Objective To investigate the change in peripheral blood CD4~+regulatory T( Treg) cells and its association with antiviral effect in patients with chronic hepatitis C( CHC). Methods A total of 85 CHC patients who completed standard antiviral therapy and follow- up in The First People's Hospital of Tianmen from January 2013 to January 2016 were enrolled as CHC group,and 40 healthy volunteers were enrolled as control group. Flow cytometry was used to measure peripheral blood CD4~+Treg cells,and the serum levels of HCV RNA,aspartate aminotransferase( AST),and alanine aminotransferase( ALT) were measured before treatment,at 12 and 48 weeks of treatment,and at24 weeks of follow- up. The t- test was used for comparison of continuous data between groups. Results Before treatment,the CHC group had significantly higher levels of HCV RNA,AST,ALT,and CD4~+Treg cells than the control group( all P < 0. 001). At 12 weeks of treatment,of all patients in the CHC group,36( 42. 35%) achieved early virological response( EVR)( EVR group) and 49( 57. 65%) did not achieve EVR( no- EVR group); the EVR group had significant reductions in the levels of HCV RNA and CD4~+Treg cells after treatment( t = 39. 241 and 8. 763,both P < 0. 001),and there were significant differences in the levels of HCV RNA and CD4~+Treg cells between the two groups( t = 76. 520 and 8. 227,both P < 0. 001). At 48 weeks of treatment,of all patients in the CHC group,49( 57. 65%)achieved end- of- treatment response( ETR)( ETR group) and 36( 42. 35%) did not achieve ETR( no- ETR group); the ETR group had significant reductions in the levels of AST,ALT,CD4~+Treg cells,and HCV RNA at 48 weeks of treatment( t = 46. 197,11. 806,15.368,and 9. 694,all P < 0. 001) and had significantly lower levels than the no- ETR group( t = 72. 612,9. 274,9. 682,and 7. 729,all P< 0. 001). At 24 weeks of follow- up,of all patients in the CHC group,39( 45. 88%) achieved sustained virological response( SVR)( SVR group),among whom 30 achieved EVR and 32 achieved ETR,and 46( 54. 12%) did not achieve SVR( no- SVR group); at 48 weeks of treatment and 24 weeks of follow- up,the SVR group had significantly lower levels of HCV RNA,AST,ALT,and CD4~+Treg cells than the no- SVR group( at 48 weeks of treatment: t = 117. 564,17. 113,10. 564,and 4. 452,all P < 0. 001; at 24 weeks of follow- up: t = 11. 196,20. 997,13. 384,and 7. 900,all P < 0. 001). Conclusion CHC patients have an increase in peripheral blood CD4~+Treg cells and antiviral therapy can effectively reduce the level of CD4~+Treg cells and alleviate liver injury. Measurement of peripheral blood CD4~+Treg cells can be used as an assessment index for the development of CHC and the effect of antiviral therapy.
- hepatitis C,chronic /
- T-lymphocytes,regulatory /
- treatment outcome

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参考文献(16)

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