乙型病毒性肝炎肝硬化门静脉高压症患者脾切除后CD4+ CD25+ CD127low/- 调节性T细胞的变化及意义

Changes and significance of CD4 +CD25 +CD127 low/- regulatory T cells in patients with portal hypertension and hepatitis B virus infection after splenectomy

    摘要
  • 摘要: 目的:观察乙型病毒性肝炎肝硬化门静脉高压症患者行脾切除术前后外周血中CD4+CD25+CD127low/-调节性T细胞(Treg)的变化，探讨门静脉高压症患者行脾切除术对机体免疫功能的影响。
    方法:回顾性分析2012年5月至2013年5月河北医科大学第三医院收治的20例乙型病毒性肝炎肝硬化门静脉高压症合并脾功能亢进患者的临床资料，通过流式细胞仪分析乙型病毒性肝炎肝硬化门静脉高压症合并脾功能亢进患者(门静脉高压症组)脾切除术前1 d、术后1周、1个月、3个月和来自河北医科大学第三医院的10例健康体检者(对照组)的外周血中CD4+CD25+CD127low/-Treg含量，分析Treg的变化对全身免疫系统造成的影响。组间比较采用t检验，手术前后数据比较采用重复测量方差分析。
    结果:门静脉高压症组患者术前和对照组受试者CD4+CD25+CD127low/-Treg比例分别为5.1%±3.5%和1.4%±0.2%，两组比较，差异有统计学意义(t=2.573，P<0.05)。门静脉高压症组患者术后1周、1个月、3个月CD4+CD25+CD127low/-Treg比例分别为9.2%±2.7%、5.6%±1.7%、2.5%±2.1%，其中术后1周与术前比较，差异有统计学意义(F=9.814，P<0.05)；而术后3个月与术前比较，差异无统计学意义(F=2.364，P>0.05)。
    结论:脾切除术后短期Treg水平明显升高，随时间延长逐渐下降。从Treg方面表明脾切除对机体免疫系统影响较小。

     

    Abstract: Objective:To detect the changes of CD4 +CD25 +CD127 low/- regulatory T (Treg) cells in peripheral blood in patients with portal hypertension and hepatitis B virus infection before and after splenectomy, and to study the effects of splenectomy on the immune function of patients with portal hypertension.
    Methods: The clinical data of 20 patients with portal hypertension, hepatitis B virus infection and hypersplenism who were admitted to the Third Hospital of Hebei Medical University from May 2012 to May 2013 were retrospectively analyzed. The dynamic levels of CD4 +CD25 +CD127 low/- Treg cells in the peripheral blood of the 20 patients (portal hypertension group) at 1 day before splenectomy and at postoperative week 1, month 1 and month 3 were detected by flow cytometry, and the dynamic levels of CD4 +CD25 +CD127 low/- Treg cells in the peripheral blood of 10 healthy individuals (control group) from the same hospital were also detected by flow cytometry. The effects of changes of Treg cells on the immune function were analyzed. All data were analyzed using the t test or repeated measures analysis of variance.
    Results:The proportions of CD4 +CD25 +CD127 low/- Treg cells before operation were 5.1%±3.5% in the portal hypertension group and 1.4%±0.2% in the control group, with significant difference between the 2 groups (t=2.573, P<0.05). The proportions of CD4 +CD25 +CD127 low/- Treg cells in the portal hypertension group at postoperative week 1, month 1 and month 3 were 9.2%±2.7%, 5.6%±1.7% and 2.5%±2.1%, respectively. There was significant difference in the proportion of CD4 +CD25 +CD127 low/- Treg cells between postoperative week 1 and that before operation (F=9.814, P<0.05), while there was no significant difference in the proportion of CD4 +CD25 +CD127 low/- Treg cells between postoperative month 3 and that before operation (F=2.364, P>0.05).
    Conclusion:The proportion of Treg cells increases in a short period after splenectomy, and then it decreases as time passed by, which indicates that splenectomy has slight influence on the immune system from the perspective of Treg cells.

     

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