摘要目的 研究慢性HBV感染者外周血自然杀伤细胞(NK细胞)免疫效应分子表达与感染状态的相关性.方法 健康人作为对照组,慢性HBV感染者根据感染状态分为肝功正常高病毒复制组、肝功能正常低病毒复制组、肝功能异常高病毒复制组、肝功能异常低病毒复制组.应用流式细胞法检测外周血NK细胞的穿孔素(PF)、颗粒酶B(Gr B)、颗粒溶素(GNLY)、肿瘤坏死因子(TNF)α和干扰素(IFN)γ的表达,分析其与感染状态的相关性.组间比较用单因素方差分析;相关性分析采用直线相关Pearson分析.结果 阳性细胞百分比同对照组(31.50%±27.64%)相比,肝功能正常高病毒复制组(59.74%±30.82%)和肝功能正常低病毒复制组(61.89%±33.30%)的GNLY表达增加有统计学意义;同对照组(57.38%±23.69%)相比,肝功正常高病毒复制组(39.89%±21.30%)、肝功能异常高病毒复制组(37.54%±18.79%)的IFN γ表达降低,P值均<0.05,差异有统计学意义;肝功能正常高病毒复制组的PF、Gr B、GNLY(阳性细胞百分比分别为56.98%±38.34%、81.53%±19.58%、59.74%±30.82%)和肝功能正常低病毒复制组的PF、Gr B、GNLY(阳性细胞百分比分别为62.95%±31.98%、84.51%±14.57%、61.89%±33.30%)表达高于肝功能异常高病毒复制组 (阳性细胞百分比分别为35.47%±29.64%,66.55%±22.92%,42.03±33.17%),P值均<0.05,差异有统计学意义;除了TNF α和GNLY不具有相关性外,PF、Gr B、GNLY、TNF α和IFN γ之间呈两两正相关关系.结论 高病毒复制水平的HBV感染者外周血NK细胞表达的IFN γ明显低于正常对照组;肝功能正常的HBV感染者外周血NK细胞表达的PF、Gr B、GNLY水平明显高于肝功能异常者.

abstractsObjective To investigate the expression profile of immune effector molecules in periph-eral natural killer cells (NK) in patients with chronic hepatitis virus B. Methods According to the infection status, patients were divided into four experiment groups: normal hepatic function and high HBV DNA level group, normal hepatic function and low HBV DNA level group, abnormal hepatic function and high HBV DNA level group and abnormal hepatic function and low HBV DNA level group. The expression of perforin (PF), granzyme B (Gr B), granulysin (GNLY), tumor necrosis factor alpha (TNF α ) and interferon gamma (IFN γ ) in NK cells were detected by flow cytometer. Results Compared with control group (31.50% ± 27.64%), the expression of GNLY was significantly increased in normal hepatic function and high HBV DNA level group (59.74% ± 30.82%) and normal hepatic function and low HBV DNA level group (61.89% ± 33.30%);the expression of IFN γ in normal hepatic function and high HBV DNA level group (39.89% ± 21.30%) and abnormal hepatic function and high HBV DNA level group (37.54% ± 18.79%) was lower than that in normal control group (57.38% ± 23.69%);the expression of PF, GrB, GNLY in abnormal hepatic function and high HBV DNA level group (35.47% ± 29.64%, 66.55% ± 22.92%, 42.03% ± 33.17%) was lower than that in normal hepatic function and high HBV DNA level group (56.98% ± 38.34%, 81.53% ± 19.58%, 59.74% ± 30.82%) and normal hepatic function and low HBV DNA level groups (62.95% ± 31.98%, 84.51% ± 14.57%, 61.89% ± 33.3%);there were positive correlations between ef PF, Gr B, GNLY, TNF α, and IFN γ. Conclusion The expression of IFN γ in NK cells from patients with high HBV DNA replication level is lower than that in normal control group;the expression of PF, Gr B and GNLY in NK cells from patients with normal hepatic function is higher than that in NK cells from patients with abnormal hepatic function.