Objective To investigate the correlation of T-lymphocyte expressing HLA-DR with serum HBV DNA and HBeAg contents in chronic hepatitis B. Methods Totally 134 chronic hepatitis B patients and 36 healthy blood donors were enrolled in the study. The T-lymphocytes (CD3 + HLA-DR + ,CD4 + HLA-DR+ and CD8 + HLA-DR+ T) expressing HLA-DR were detected by flow cytometry, the serum HBV viral loads were detected by the real-time quantitative PCR and HBeAg was detected by chemiluminescence method. According to serum HBV DNA viral loads patients were defined as HBV DNA negative (≤ 103 copies/mL), low (＞ 103 - 105 copies/mL), medium (＞ 105 - 107 copies/mL) and high groups (＞ 107 - 109 copies/mL) ; according to serum HBeAg levels, patients were defined as HBeAg negative (≤1 PEIU/mL), low (＞ 1 - 100 PEIU/mL), medium (＞ 100-1 000 PEIU/mL) and high groups (＞ 1 000-10 000 PEIU/mL). T test and one-way ANOVA were performed. Results With HBV DNA loads, HBeAg levels increased, the percentage of CD3 + HLA-DR + , CD4 + HLA-DR + and CD8 + HLA-DR +decreased, especially CD8 + HLA-DR +. Compared with HBV DNA negative group, the percentages of CD3 +HLA-DR + , CD4 + HLA-DR + and CD8 + HLA-DR + were significantly reduced in high group (t = 3. 686,4. 592 and 3. 216, P ＜ 0. 0l); the percentages of CD4 + HLA-DR + and CD8 + HLA-DR + were also reduced in medium group (t = 3. 761 and 2.862, P ＜ 0.01); while in low group, only the percentage of CD8 + HLA-DR + was reduced (t = 2.215, P ＜ 0.05). Compared with HBeAg negative group, the percentages of CD3 +HLA-DR+, CD4 + HLA-DR+ and CD8 + HLA-DR+ were significantly reduced in medium and high groups (thigher =3. 144, 2.222 and 4.035; tmiddle =3.311, 2.362 and 3.374, P ＜0.05), while in the low group,only the percentage of CD8+HLA-DR+ was reduced (t=2.029, P＜0. 05). Conclusion The combined measurement of HBV DNA, HBeAg and T-lymphocytes expressing HLA-DR in chronic hepatitis B patients may not only help to evaluate the immune status of patients, but also can predict the disease progression and clinical outcomes.%目的 探讨慢性乙型肝炎(CHB)患者HBV DNA、HBeAg含量不同时外周血T淋巴细胞人白细胞抗原DR(HLA-DR)的表达情况.方法 收集2008年9月-2009年10月杭州市第六人民医院134例CHB患者,另外选取36名健康体检者作为对照.用流式细胞仪检测所有研究对象外周血CD3+HLA-DR+、CD4+HLA-DR+和CD8+HLA-DR+T淋巴细胞HLA-DR抗原的表达;实时荧光定量PCR法检测血清HBV DNA含量,化学发光法定量检测血清HBeAg含量.所有患者根据血清HBV DNA载量分为HBV DNA阴性组(≤103拷贝/mL)、低载量组(＞103～105拷贝/mL)、中载量组(＞105～107拷贝/mL)和高载量组(＞107～109拷贝/mL);根据血清HBeAg含量分为HBeAg阴性组(≤1 PEIU/mL)、低含量组(＞1～100 PEIU/mL)、中含量组(＞100～1 000 PEIU/mL)和高含量组(＞1 000～10 000 PEIU/mL).组间比较采用t检验和单因素方差分析.结果随着HBV DNA、HBeAg含量的升高,CD3+HLA-DR+、CD4+HLA-DR+和CD8+HLA-DR+细胞百分比降低,其中CD8+HLA-DR+细胞百分比降低尤为明显.与HBV DNA阴性组比较,高载量组CD3+HLA-DR+、CD4+HLA-DR+和CD8+HLA-DR+细胞百分比均明显减少,差异具有统计学意义(t=3.686、4.592和3.216,P值均＜0.01);中载量组CD4+HLA-DR+和CD8+HLA-DR+细胞百分比均明显减少,差异具有统计学意义(t=3.761和2.862,P值均＜0.01);低载量组CD8+HLA-DR+细胞百分比明显减少,差异有统计学意义(t=2.215,P值＜0.05).与HBeAg阴性组比,HBeAg高含量组、中含量组CD3+HLA-DR+、CD4+HLA-DR+和CD8+HLA-DR+细胞百分比均明显减少,差异具有统计学意义(t高含量=3.144、2.222和4.035;t中含量=3.311、2.362和3.374,P值均＜0.05);HBeAg低含量组CD8+HLA-DR+细胞百分比明显减少,差异具有统计学意义(t=2.029,P值＜0.05).结论 联合检测患者血清HBV DNA、HBeAg含量以及T淋巴细胞HLA-DR抗原表达不仅有助于评价CHB患者的免疫状况,对疾病进展和临床疗效评价也具有一定的指导意义.
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