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目的探讨CD4+CD25+Treg细胞在慢性丙型病毒性肝炎(chronic hepatitis C,CHC)患者干扰素治疗过程中的疗效判断作用。方法选取2013年10月至2014年8月收治的150例CHC患者,利用流式细胞术计数患者外周血CD4+CD25+Treg细胞的数量,使用实时荧光PCR检测HCV RNA含量。随访观察患者在α干扰素和利巴韦林治疗前和治疗24周后的CD4+CD25+Treg细胞和HCV RNA的变化情况。根据HCV RNA载量情况分为低载量组、中载量组和高载量组;根据治疗前后HCV RNA的变化情况分为转阴组、慢反应组和不反应组。结果 CHC患者性别和年龄在不同HCV RNA载量无统计学差异,而HCV RNA载量与CHC患者外周血CD4+CD25+Treg细胞量间差异显著,两者呈正相关(r=0.996,P=0.005)。同时,CHC患者经α干扰素和利巴韦林治疗24周后,转阴组外周血CD4+CD25+Treg细胞水平从(8.41±2.08)%降至(3.96±1.94)%(P<0.001),慢反应组细胞水平从(8.26±2.59)%降至(5.92±2.35)%(P<0.001),具有统计学意义;而不反应组外周血CD4+CD25+Treg细胞水平反而升高,从(8.61±2.31)%升至(10.42±2.18)%(P<0.001),具有统计学意义。结论 CHC患者HCV RNA载量与其外周血CD4+CD25+Treg细胞量呈正相关。经α干扰素和利巴韦林治疗24周后,外周血CD4+CD25+Treg细胞随着HCV RNA的降低而降低,而HCV RNA经治疗降低无效时,CD4+CD25+Treg细胞反而会升高。提示CD4+CD25+Treg细胞可能参与丙型肝炎的进展,为研究丙型肝炎患者的治疗是否有效提供了新的思路。
Objective To investigate the therapeutic effect of CD4 + CD25 + Treg cells in interferon therapy in patients with chronic hepatitis C (CHC). Methods A total of 150 patients with CHC admitted from October 2013 to August 2014 were enrolled. The numbers of CD4 + CD25 + Treg cells in peripheral blood were counted by flow cytometry and the content of HCV RNA was detected by real-time fluorescence PCR. The changes of CD4 + CD25 + Treg cells and HCV RNA in patients before and 24 weeks after treatment with interferon alpha and ribavirin were observed. According to the HCV RNA load, the patients were divided into low-load group, middle-load group and high-load group. According to the change of HCV RNA before and after treatment, they were divided into negative-negative group, slow-response group and non-reactive group. Results The gender and age of CHC patients showed no significant difference in the load of HCV RNA, while there was a significant difference between HCV RNA load and CD4 + CD25 + Treg cells in CHC patients (r = 0.996, P = 0.005 ). At the same time, the level of CD4 + CD25 + Treg cells in the peripheral blood of patients with CHC decreased from (8.41 ± 2.08)% to (3.96 ± 1.94)% (P <0.001) after treatment with interferon alpha and ribavirin for 24 weeks in CHC patients. (8.26 ± 2.59)% (5.92 ± 2.35)%, respectively (P <0.001), and the level of CD4 + CD25 + Treg cells in non-response group increased from (8.61 ± 2.31)% to (10.42 ± 2.18)% (P <0.001), respectively, with statistical significance. Conclusion The HCV RNA load in CHC patients is positively correlated with the amount of CD4 + CD25 + Treg cells in peripheral blood. CD4 + CD25 + Treg cells in peripheral blood decreased with the decrease of HCV RNA after 24 weeks of treatment with interferon-α and ribavirin, whereas CD4 + CD25 + Treg cells increased in the absence of effective treatment of HCV RNA . It is suggested that CD4 + CD25 + Treg cells may participate in the progress of hepatitis C, which provides a new idea for studying whether the treatment of hepatitis C patients is effective.