乙肝肝炎患者PBMC中IFN-γ、IL-17、γδT与血清中HBeAg/HBeAb之间的相关性及其临床意义分析

尹凌凡 熊建辉 王梦洁 孙黎辉

[摘要] 目的 探討乙肝肝炎患者PBMC中IFN-γ、IL-17、γδ T水平与血清中HBeAg/HBeAb之间的相关性及其临床意义分析。 方法 随机选取2016年9月～2017年9月我院治疗的乙肝肝炎患者90例作为研究组，选取同期检测的90例正常健康人作为对照组。观察并记录两组患者PBMC中IFN-γ、IL-17、γδ T水平与血清中HBeAg/HBeAb之间的相关性。 结果 研究组PBMC中IFN-γ和γδ T均高于对照组，而IL-17无差异。研究组间患者PBMC的γδ T在HBeAg+/HBeAb+组高于HBeAg-/HBeAb+组（P<0.05），而与HBeAg+/HBeAb-组相差不大（P>0.05），而CD8+IL-17在HBeAg+/HBeAb+组水平要明显高于HBeAg+/HBeAb-组和HBeAg-/HBeAb+组（P<0.05），而IFN-γ+γδ T和IL-17+γδ T在各研究组间无差异。HBeAg+/HBeAb-组血清内HBV-DNA水平要明显高于HBeAg+/HBeAb+组和HBeAg-/HBeAb+组（P<0.05），HBeAg+/HBeAb+组和HBeAg-/HBeAb+组之间无差异（P>0.05）。 结论 CD8+IL-17水平在 HBeAg/HBeAb血清转换中的乙肝肝炎患者PBMC中高于HBeAg/HBeAb血清转换前后，提示Tc17细胞在慢性乙肝良性转归中起关键作用，Tc17的高表达预示慢性乙肝患者HBeAg/HBeAb血清转换的可能性大。

[关键词] 乙肝;肝炎患者;IFN-γ;IL-17;γδ T;HBeAg/HBeAb;血清

[中图分类号] R512.62          [文献标识码] A          [文章编号] 1673-9701（2019）08-0029-04

[Abstract] Objective To investigate the correlation between IFN-γ， IL-17， γδ T of PBMC and serum HBeAg/HBeAb in patients with hepatitis B and its clinical significance. Methods 90 patients with hepatitis B who were treated in our hospital from September 2016 to September 2017 were randomly selected as the study group. 90 normal healthy persons tested at the same time were selected as the control group. The correlation between the amount of IFN-γ， IL-17， γδ T in PBMC and HBeAg/HBeAb in serum was observed and recorded. Results IFN-γ and γδ T in the PBMC of the study group was higher than that in the control group， but there was no difference in IL-17. The γδ T of PBMC in the HBeAg+/HBeAb+ group was higher than that in the HBeAg-/HBeAb+ group（P<0.05）， but was similar to that in the HBeAg+/HBeAb-group（P>0.05）. The level of CD8+IL-17 in HBeAg+ /HBeAb+ group was significantly higher than that in HBeAg+/HBeAb- group and HBeAg-/HBeAb+ group（P<0.05）， while there was no significant difference in IFN-γ +γδ T and IL-17+γδ among the study groups. The level of HBV-DNA in HBeAg+/HBeAb- group was significantly higher than that between the HBeAg+/HBeAb+ group and HBeAg-/HBeAb+ group（P<0.05）， while there was no significant difference of HBV-DNA between the HBeAg+/HBeAb+ group and HBeAg-/HBeAb+ group. Conclusion The level of CD8+IL-17 in PBMC of hepatitis B patients with HBeAg/HBeAb seroconversion is higher than that before HBeAg/HBeAb seroconversion， suggesting that Tc17 cells play a key role in the benign outcome of chronic hepatitis B. High expression of Tc17 predicts chronic hepatitis B Patients are more likely to have HBeAg/HBeAb seroconversion.