尹凌凡 熊建輝 王夢潔 孫黎輝

[摘要] 目的 探討乙肝肝炎患者PBMC中IFN-γ、IL-17、γδ T水平與血清中HBeAg/HBeAb之間的相關(guān)性及其臨床意義分析。 方法 隨機(jī)選取2016年9月～2017年9月我院治療的乙肝肝炎患者90例作為研究組，選取同期檢測的90例正常健康人作為對照組。觀察并記錄兩組患者PBMC中IFN-γ、IL-17、γδ T水平與血清中HBeAg/HBeAb之間的相關(guān)性。 結(jié)果 研究組PBMC中IFN-γ和γδ T均高于對照組，而IL-17無差異。研究組間患者PBMC的γδ T在HBeAg+/HBeAb+組高于HBeAg-/HBeAb+組（P<0.05），而與HBeAg+/HBeAb-組相差不大（P>0.05），而CD8+IL-17在HBeAg+/HBeAb+組水平要明顯高于HBeAg+/HBeAb-組和HBeAg-/HBeAb+組（P<0.05），而IFN-γ+γδ T和IL-17+γδ T在各研究組間無差異。HBeAg+/HBeAb-組血清內(nèi)HBV-DNA水平要明顯高于HBeAg+/HBeAb+組和HBeAg-/HBeAb+組（P<0.05），HBeAg+/HBeAb+組和HBeAg-/HBeAb+組之間無差異（P>0.05）。 結(jié)論 CD8+IL-17水平在 HBeAg/HBeAb血清轉(zhuǎn)換中的乙肝肝炎患者PBMC中高于HBeAg/HBeAb血清轉(zhuǎn)換前后，提示Tc17細(xì)胞在慢性乙肝良性轉(zhuǎn)歸中起關(guān)鍵作用，Tc17的高表達(dá)預(yù)示慢性乙肝患者HBeAg/HBeAb血清轉(zhuǎn)換的可能性大。

[關(guān)鍵詞] 乙肝;肝炎患者;IFN-γ;IL-17;γδ T;HBeAg/HBeAb;血清

[中圖分類號] R512.62 ? ? ? ? ?[文獻(xiàn)標(biāo)識碼] A ? ? ? ? ?[文章編號] 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.