核苷(酸)类似物对慢性乙型肝炎的疗效及与外周血调节性T细胞的相关性

何俊楠; 赵守松

doi:10.13898/j.cnki.issn.1000-2200.2019.03.015

核苷(酸)类似物对慢性乙型肝炎的疗效及与外周血调节性T细胞的相关性

Effect of the nucleoside analogues in the treatment of chronic hepatitis B and its correlation with regulatory T cells of peripheral blood

摘要

摘要:
目的探讨核苷（酸）类似物治疗过程中慢性乙型肝炎（CHB）病人外周血中调节性T细胞（Treg）表达水平的变化及临床意义。
方法选取130例接受核苷（酸）类似物治疗的CHB病人，治疗前及治疗48周时，分别以流式细胞仪检测外周血CD4⁺CD25⁺CD127^Low/- Tregs比例。
结果治疗前，免疫耐受组、免疫清除组及健康对照组间CD4⁺CD25⁺CD127^Low/- Treg水平差异有统计学意义（P < 0.01），其中免疫清除组与免疫耐受组和健康对照组差异均有统计学意义（P < 0.01和P < 0.05），而免疫清除组与健康对照组差异无统计学意义（P>0.05）；治疗48周时，HBeAg未变化组、HBeAg转阴组、HBeAg血清转换组、健康对照组CD4⁺CD25⁺CD127^Low/- Treg细胞水平差异均有统计学意义（P < 0.05），HBeAg未变化组与HBeAg转阴组和健康对照组Treg细胞差异均有统计学意义（P < 0.05），而HBeAg转阴组、HBeAg血清转换组与健康对照组差异无统计学意义（P>0.05）；48周治疗后乙型肝炎病毒（HBV）复常组与HBV未复常组Treg差异无统计学意义（P>0.05）；ALT复常组与ALT未复常组差异无统计学意义（P>0.05）。
结论CHB病人经核苷（酸）类似物治疗过程中CD4⁺CD25⁺CD127^Low/- Treg细胞水平变化与HBeAg是否发生血清转换、HBV是否复常有关，对核苷（酸）类似物治疗的疗效及预后有一定的预测价值。

Abstract:
ObjectiveTo investigate the expression levels of regulatory T cells (Treg) in peripheral blood of chronic hepatitis B (CHB) patients during the treatment with nucleoside analogues, and its clinical significance.
MethodsThe ratio of CD4⁺CD25⁺CD127^Low/- Tregs in 130 CHB patients treated with nucleoside analogues was detected using flow cytometry before treatment and after 48 weeks of treatment.
ResultsBefore treatment, the differences of the levels of CD4⁺CD25⁺CD127^Low/- Treg among immune tolerance group, immune clearance group and healthy control group were statistically significant (P < 0.01), the differences of the levels of CD4⁺CD25⁺CD127^Low/- Treg between immune tolerance group, and immune clearance group, healthy control group were statistically significant (P < 0.01 and P < 0.05), but the difference of the level CD4⁺CD25⁺CD127^Low/- Treg between immune clearance group and healthy control group was not statistically significant (P>0.05).After 48 weeks of treatment, the differences of the levels of CD4⁺CD25⁺CD127^Low/- Treg among HBeAg unchanged group, HBeAg conversion negative group, HBeAg serum conversion group and healthy control group were statistically significant (P < 0.05), the differences of the levels of CD4⁺CD25⁺CD127^Low/- Treg between HBeAg unchanged group and HBeAg conversion negative group, healthy control group were statistically significant (P < 0.05), and the differences of the levels of CD4⁺CD25⁺CD127^Low/- Treg among HBeAg conversion negative group, HBeAg serum conversion group and healthy control group were not statistically significant (P>0.05).After 48 weeks of treatment, the difference of the level of Treg between HBV normalization group and HBV no normalization group was not statistically significant (P>0.05), and the difference of the level of Treg between ALT normalization group and ALT no normalization group was not statistically significant (P>0.05).
ConclusionsDuring the treatment of CHB patients with nucleoside analogues, the level of CD4⁺CD25⁺CD127^Low/- Treg may be related to the HBeAg seroconversion and HBV normalization, which has certain predictive value in the efficacy and prognosis of disease.

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