梅毒与梅毒合并病毒性肝炎患者外周血T淋巴细胞亚群变化*

doi:10.3969/j.issn.1672-5069.2022.01.009

摘要/Abstract

摘要： 目的调查梅毒及其合并病毒性肝炎患者外周血T淋巴细胞亚群的变化。方法 2016年1月～2020年6月我院收治的93例感染苍白螺旋体(TP)梅毒患者中,单纯梅毒感染61例,TP合并CHB患者21例和TP合并CHC患者11例,另选择健康体检者84例。使用流式细胞仪检测外周血T淋巴细胞亚群。结果梅毒患者外周血CD3⁺、CD4⁺、CD4⁺CD45RO⁺和CD8⁺CD45RA⁺细胞百分比及CD4⁺/CD8⁺细胞比值分别为(52.2±8.5)%、(40.3±5.7)%、(18.1±3.9)%、(12.4±3.7)%和(1.2±0.3),均显著低于健康人[分别为(69.1±7.6)%、(50.7±6.9)%、(20.6±4.7)%、(16.2±4.3)%和(1.9±0.5),P＜0.05],而外周血CD8⁺、CD4⁺CD45RA⁺和CD8⁺CD45RO⁺细胞百分比显著高于健康人[分别为(32.4±7.3)%、(24.7±6.5)%和(8.7±1.5)%对(26.2±5.4)%、(21.8±6.2)%和(5.4±1.1)%,P＜0.05];三组外周血CD8⁺、CD4⁺CD45RA⁺、CD4⁺CD45RO⁺、CD8⁺CD45RA⁺和CD8⁺CD45RO⁺细胞百分比及CD4⁺/CD8⁺细胞比值比较,差异有统计学意义(P＜0.05),TP合并CHB组和TP合并CHC组患者外周血CD8⁺、CD4⁺CD45RA⁺和CD8⁺CD45RO⁺细胞百分比均显著高于TP组(P＜0.05),而TP合并CHB组和TP合并CHC组患者外周血CD4⁺/CD8⁺比值、CD4⁺CD45RO⁺和CD8⁺CD45RA⁺细胞百分比显著低于TP组(P＜0.05),TP合并CHB组与TP合并CHC组患者外周血CD8⁺、CD4⁺CD45RA⁺、CD4⁺CD45RO⁺、CD8⁺CD45RA⁺和CD8⁺CD45RO⁺细胞百分比及CD4⁺/CD8⁺细胞比值比较均无统计学差异(P＞0.05)。结论梅毒患者存在显著的外周血淋巴细胞亚群变化,合并CHB或合并CHC患者细胞免疫功能变化更明显,其临床意义值得进一步探讨。

关键词: 梅毒, 乙型肝炎, 丙型肝炎, T淋巴细胞亚群, 混合感染

Abstract: Objective The aim of this study was to investigate the clinical implication of peripheral blood T lymphocyte subset changes in patients with syphilis and hepatitis B or hepatitis C coinfection. Methods 93 patients with treponema pallidum (TP) syphilis were admitted to our hospital between January 2016 and June 2020, including syphilis infection in 61 cases, syphilis with hepatitis B virus infection in 21 cases and syphilis with hepatitis C virus infection in 11 cases. 84 healthy persons were selected as the control. The peripheral blood T lymphocyte subsets was assayed by FCM. Results The percentages of peripheral blood CD3⁺, CD4⁺, CD4⁺CD45RO⁺ and CD8⁺CD45RA⁺ cells as well as the ratio of CD4⁺/CD8⁺ cells in patients with syphilis were(52.2±8.5)%,(40.3±5.7)%,(18.1±3.9)%, (12.4±3.7)% and (1.2±0.3), all significantly lower than [(69.1±7.6)%,(50.7±6.9)%,(20.6±4.7)%,(16.2±4.3)% and (1.9±0.5), respectively, P＜0.05], while the percentages of peripheral blood CD8⁺, CD4⁺CD45RA⁺and CD8⁺CD45RO⁺ cells were all significantly higher than those in healthy control [(32.4±7.3)%, (24.7±6.5)% and (8.7±1.5)% vs. (26.2±5.4)%, (21.8±6.2)% and (5.4±1.1)%, respectively, P＜0.05]; there were significant differences as respect to the percentages of peripheral blood CD8⁺, CD4⁺CD45RA⁺, CD4⁺CD45RO⁺, CD8⁺CD45RA⁺, CD8⁺CD45RO⁺ cells and the ratio of CD4⁺/CD8⁺ cells among patients with TP, with TP and chronic hepatitis B (CHB), and with TP and chronic hepatitis C (CHC, P＜0.05), the percentages of CD8⁺, CD4⁺CD45RA⁺ and CD8⁺CD45RO⁺ cells in patients with TP and CHB and patients with TP and CHC were all significantly higher than those in patients with TP(P＜0.05), while the ratio of CD4⁺/CD8⁺ cells, and the percentages of blood CD4⁺CD45RO⁺ and CD8⁺CD45RA⁺ cells were all significantly lower than those in patients with TP (P＜0.05); there were no significant differences respect to the percentage of blood CD8⁺, CD4⁺CD45RA⁺, CD4⁺CD45RO⁺, CD8⁺CD45RA⁺ and CD8⁺CD45RO⁺ cells and the ratio of CD4⁺/CD8⁺ cells between patients with TP and CHB, and those with TP and CHC (P＞0.05). Conclusion The percentages of peripheral blood CD3⁺, CD4⁺, CD8⁺, CD4⁺CD45RA⁺, CD8⁺CD45RO⁺, CD4⁺CD45RO⁺, CD8⁺CD45RA⁺ and the ratio of CD4⁺/CD8⁺ cells in patients with TP change greatly, and those in patients with TP and HBV or HCV mixed infection change even significantly, which needs further clinical investigation.

Key words: Syphilis, Hepatitis B, Hepatitis C, T lymphocytes, Mixed infection

屈晓威, 冯莉莉, 貌彦昀. 梅毒与梅毒合并病毒性肝炎患者外周血T淋巴细胞亚群变化^*[J]. 实用肝脏病杂志, 2022, 25(1): 34-37.

Qu Xiaowei, Feng Lili, Mao Yanyun. Clinical implication of peripheral blood T lymphocyte subset changes in patients with syphilis and hepatitis B or hepatitis C coinfection[J]. Journal of Practical Hepatology, 2022, 25(1): 34-37.

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梅毒与梅毒合并病毒性肝炎患者外周血T淋巴细胞亚群变化^*

Clinical implication of peripheral blood T lymphocyte subset changes in patients with syphilis and hepatitis B or hepatitis C coinfection

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