MDSC在外周血中的表达及其与HBV-DNA复制水平的相关性

目的探讨髓源性抑制细胞（MDSC）在乙肝HBe Ag阳性﹑HBe Ab阳性患者外周血中的表达水平及临床意义,并进一步分析MDSC与HBV-DNA的动态关系。方法 （1）选取乙肝两对半符合HBe Ag阳性﹑HBe Ab阳性表型的患者60例,将这些标本分为HBe Ag阳性组、HBe Ab阳性组。分析MDSC在这两组间的表达差别。（2）将患者分为HBV-DNA阳性组和HBV-DNA阴性组,分析HBV-DNA的复制水平与MDSC表达的相关性。（3）用流式细胞仪检测外周血中以CD33^＋CD11b^＋HLA-DR^-为特征的MDSC占外周血粒细胞的百分比。（4）结合患者的其他指标（ALT、AST、GGT）,利用统计学软件分析其与MDSC表达水平之间的关系,进一步探讨它的临床意义。结果乙肝（HBe Ag阳性）MDSC表达水平（10.85±4.21）（n=22）（t=12.091）高于HBe Ab阳性组（5.88±2.95）（n=38）（t=12.281）（P〈0.01）,结果差异有统计学意义;乙肝DNA阳性组中MDSC表达水平（9.30±4.44）（n=30）（t=11.473）显著高于DNA阴性组（6.10±3.29）（n=30）（t=10.161）（P〈0.01）;乙肝患者外周血中的MDSC表达水平与ALT、AST、GGT成正相关。结论乙肝HBe Ag阳性、HBe Ab阳性阳患者外周血中的MDSC表达水平可能与乙肝的发生、发展密切相关;MDSC的表达水平与HBV-DNA复制水平呈正相关;外周血MDSC表达水平可作为乙肝患者临床监测的指标。

The expression level of MDSC in peripheral blood of patients with common phenotype hepatitis B and its correlation with HBV-DNA replication level

Objective To study the expression and clinical significance of MDSC cells in peripheral blood of hepatitis B patients with positive HBe Ag and HBe Ab,and its correlation with HBV-DNA replication level. Methods The peripheral blood specimens of 60 HBV patients with positive HBe Ag and HBe Ab were collected and divided into two groups： HBe Ag positive group and HBe Ab positive group. The difference of MDSC expression between the two groups were analyzed. The patients were then divided into HBV-DNA positive group and HBV-DNA negative group,and the correlation between the MDSC expression and HBV-DNA replication were analyzed. Flow cytometry was used to detect the ratio of MDSC with CD33＋CD11b＋HLA-DR-expression in peripheral blood granulocytes.The software SPSS was used to analyze the correlation between other clinical indicators（ AST,ALT,GTT） and the proportion of CD33^＋CD11b^＋HLA-DR^-MDSC. Results 1. The proportion of CD33＋CD11b＋HLA-DR-MDSC in the peripheral blood of HBe Ag positive group was higher（ 10. 85 ± 4. 21; n = 22; t = 12. 091） than that of the HBe Ab positive group（ 5. 88 ± 2. 95; n = 38; t = 12. 281）（ P〈0. 01）. The MDSC expression in HBV-DNA（ ＋）patients（ 9. 30 ± 4. 44; n = 30; t = 11. 473） was significantly higher than in HBV-DNA（-） patients（ 6. 10 ±3. 29; n = 30; t = 10. 161）（ P〈0. 01）. The MDSC expression level in the peripheral blood of Hepatitis B patients had positive relationship with ALT,AST and GGT. Conclusion The proportion of CD33＋CD11b＋HLA-DR-MDSC in peripheral blood of Hepatitis B patients is related to the occurrence and progression of HBV,which has positive relationship with HBV-DNA,and may become a good clinical indicator for Hepatitis B.