中西医结合肝病杂志2025，Vol.35Issue(10)：1214-1218,5.DOI:10.3969/j.issn.1005-0264.2025.010.005
CHB患者外周血CD4+、CD8+T淋巴细胞与血清HBsAg、HBV DNA定量及HBV相关性肝纤维化的关系
Relationship between peripheral blood T-lymphocytes CD4+and CD8+and serum HBsAg,HBV DNA quantification and HBV-associated hepatic fibrosis in patients with CHB
摘要
Abstract
Objective:To investigate the relationship between peripheral blood CD4+and CD8+T-lymphocyte and serum hepatitis B surface antigen(HBsAg),hepatitis B virus deoxyribonucleic acid(HBV DNA)quantification,and HBV-associated liver fibrosis in patients with chronic hepatitis B(CHB).Methods:153 patients with CHB attending our outpatient clinic from January 2021 to December 2022 were selected and grouped according to their liver pathology results for the degree of occurrence of liver fibrosis,and were divided into 111 cases in the S0～S1 group and 42 cases in the S2～S4 group.Another 50 cases of health check-ups in the same period were selected as the healthy group and the levels of peripheral blood CD4+,CD8+T-lymphocytes were detected by flow cytometry,serum HBsAg levels by luminescent microparticle immunoassay,and quantitative HBV DNA levels by real-time fluorescence quantitative assay,the general data and the levels of routine indexes of the patients in the 2 groups were collected,the correlation between peripheral blood CD4+and CD8+T-lymphocyte and quantitative serum HBsAg and HBV DNA was analyzed by Pearson's method,and the influencing factors on the occurrence of liver fibrosis in CHB patients were analyzed by logistic regression model,and the work characteristics of subjects were analyzed by using the subject work characteristics(ROC)curves were used to analyze the assessed value of peripheral blood CD4+,CD8+T lymphocytes and quantitative serum HBsAg and HBV DNA levels for HBV-associated liver fibrosis.Results:The levels of AST and ALT were higher in the S2～S4 group than in the S0～S1 group(P<0.05).Compared with the healthy group,the CD4+T lymphocyte level was lower and CD8+T lymphocyte was higher in both the S0～S1 and S2～S4 groups,and the CD4+T lymphocyte level in the S2～S4 group was lower than that in the S0～S1 group,and the levels of CD8+T lymphocyte,serum HBsAg,and HBV DNA were higher than those in the S0～S1 group(P<0.05).Pearson correlation analysis showed a negative correlation between CD4+T lymphocyte and HBsAg,and HBV DNA,and a positive correlation between CD8+T lymphocyte and HBsAg,and HBV DNA(P<0.05).Pathological results showed that the general information of the two groups was not statistically significant(P>0.05).The peripheral blood CD4+and CD8+T-lymphocytes were taken as a group,and the serum HBsAg,HBV DNA quantitative levels as independent variables were included in the logistic regression analysis model,and the results showed that peripheral blood CD4+,CD8+T-lymphocytes and serum HBsAg and HBV DNA quantification were all risk factors for the development of liver fibrosis in CHB patients(P<0.05).ROC curve analysis showed that CD4+,CD8+,serum HBsAg,HBV DNA alone assessed the area under the curve(AUC)(0.95%CI)for the occurrence of hepatic fibrosis in CHB patients to be0.770(0.695～0.834),0.775(0.701～0.839),0.845(0.778～0.898),and 0.819(0.748～0.876),respectively,and the combined assessed of the AUC by using log(P)(0.95%CI)was0.937(0.886～0.970),and the joint assessed efficacy was better than the individual assessed efficacy(P<0.05).Conclusion:Peripheral blood CD4+and CD8+T-lymphocyte levels are abnormally expressed in CHB patients and are closely correlated with quantitative serum HBsAg and HBV DNA levels,which are risk factors affecting the development of HBV-associated liver fibrosis.关键词
慢性乙型肝炎/乙型肝炎病毒表面抗原/乙型肝炎病毒脱氧核糖核酸/肝纤维化Key words
Chronic hepatitis B/hepatitis B surface antigen/hepatitis B virus deoxyribonucleic acid/liver fibrosis分类
医药卫生引用本文复制引用
李立明,曾淼,刘易..CHB患者外周血CD4+、CD8+T淋巴细胞与血清HBsAg、HBV DNA定量及HBV相关性肝纤维化的关系[J].中西医结合肝病杂志,2025,35(10):1214-1218,5.基金项目
湖北省卫生健康委员会项目(No.ZY2019Z003) （No.ZY2019Z003）
