干扰素治疗前后慢性乙型肝炎...胞表面CD64表达变化观察_尚鹏程.pdf

山东医药2023 年第 63 卷第 3 期干扰素治疗前后慢性乙型肝炎患者外周血淋巴细胞和中性粒细胞表面CD64表达变化观察尚鹏程，许娇，钟晶，毕雷成都市公共卫生临床医疗中心检验科，成都 610000摘要：目的通过观察干扰素治疗前后慢乙肝（CHB）患者外周血淋巴细胞和中性粒细胞表面CD64表达量的变化，明确外周血淋巴细胞和中性粒细胞表面CD64表达量与HBsAg、HBV-DNA、ALT水平的相关性，为下一步探讨外周血淋巴细胞和中性粒细胞表面CD64是否可用于评估干扰素治疗效果提供参考资料。方法收集57例CHB患者，其中e抗原阳性组33例、e抗原阴性组24例，均采用干扰素治疗48周。另选同期健康体检者16例为对照组。采用流式细胞术检测外周血淋巴细胞及中性粒细胞表面CD64，干扰素治疗前，治疗8、12、24、48周时比较各组患者外周血淋巴细胞及中性粒细胞表面CD64表达量。采用Pearson相关分析干扰素治疗不同时间CHB患者外周血淋巴细胞及中性粒细胞表面CD64表达量与HBsAg、HBV-DNA、ALT水平的相关性。结果干扰素治疗前，CHB患者外周血淋巴细胞表面CD64和中性粒细胞表面CD64表达量均高于对照组（P均0.05）。与对照组比较，e抗原阳性组及e抗原阴性组淋巴细胞表面CD64表达量高（P0.05；与对照组比较，e抗原阳性组中性粒细胞表面CD64表达量高（P0.05），e抗原阳性组高于e抗原阴性组（P0.05）。干扰素治疗后，CHB患者淋巴细胞表面CD64和中性粒细胞表面CD64表达量均下降，与干扰素治疗前比较，从干扰素治疗24周开始，淋巴细胞表面CD64表达量差异有统计学意义（P0.05），从干扰素治疗48周开始中性粒细胞表面CD64表达量差异有统计学意义（P0.05）。干扰素治疗不同时间，CHB患者淋巴细胞表面CD64和中性粒细胞表面CD64表达量与HBsAg、ALT水平均有相关性（P均0.05）。结论与健康对照比，CHB患者外周血淋巴细胞表面和中性粒细胞表面CD64表达量升高，干扰素治疗后淋巴细胞表面CD64和中性粒细胞表面CD64表达量下降；淋巴细胞表面和中性粒细胞表面CD64表达量与HBsAg、ALT水平有正相关关系。关键词：免疫球蛋白Fc gamma受体I型；淋巴细胞；中性粒细胞；慢性乙型肝炎；干扰素-doi：10.3969/j.issn.1002-266X.2023.03.005 中图分类号：R4 文献标志码：A 文章编号：1002-266X（2023）03-0022-04Changes of CD64 expression on surface of peripheral blood lymphocytes and neutrophils in patients with chronic hepatitis B before and after interferon treatmentSHANG Pengcheng，XU Jiao，ZHONG Jing，BI LeiClinical Laboratory，Public Health Clinical Center of Chengdu，Chengdu 610000，ChinaAbstract：Objective To clarify the correlations between CD64 expression levels on the surface of peripheral blood lymphocytes and neutrophils and the levels of HBsAg，HBV-DNA and ALT by observing the changes of CD64 expression levels on the surface of peripheral blood lymphocytes and neutrophils of patients with chronic hepatitis B（CHB）before and after interferon treatment in order to provide reference for further study on whether the CD64 on the surface of peripheral blood lymphocytes and neutrophils can be used to evaluate the effect of interferon therapy.Methords Fifty-seven CHB patients were collected，including 33 in the e antigen-positive group and 24 in the e antigen-negative group.All patients were treated with interferon for 48 weeks.Another 16 healthy subjects in the same period were selected as the control group.Flow cytometry was used to detect CD64 on the surface of peripheral blood lymphocytes and neutrophils.Before treatment with interferon，the expression levels of CD64 on the surface of peripheral blood lymphocytes and neutrophils were compared at 8，12，24 and 48 weeks of treatment.Pearson correlation was used to analyze the correlation between CD64 expression levels and HBsAg，HBV-DNA and ALT levels on peripheral blood lymphocytes and neutrophils of CHB 基金项目：四川省卫生健康委员会基金项目（16PJ083）。第一作者简介：尚鹏程（1982-），男，硕士，副主任技师，主要研究方向为感染免疫分子机制。E-mail：通信作者简介：许娇（1985-），副主任技师，主要研究方向为感染性疾病的实验室诊断。E-mail：开放科学（资源服务）标识码（OSID）22山东医药2023 年第 63 卷第 3 期patients treated with interferon at different time.Results Before interferon treatment，the expression of CD64 on the surface of peripheral blood lymphocytes and on the surface of neutrophils in patients with CHB was higher than that in the control group（P0.05）.Compared with the control group，the expression of CD64 on the surface of neutrophils was higher in the e antigen-positive group，and that in the e antigen-positive group was higher than that in the e antigen-negative group（P0.05）.After interferon treatment，the expression of CD64 on lymphocyte surface and on neutrophil surface in patients with CHB decreased.Compared with those before interferon treatment，there was significant differences in the CD64 expression on the lymphocyte surface from 24 weeks of interferon treatment（P0.05），and in the CD64 expression on neutrophil surface from 48 weeks of interferon treatment（P0.05）.At different time of interferon treatment，the expression of CD64 on the surface of lymphocytes and on the surface of neutrophils in CHB patients was correlated with the levels of HBsAg and ALT（both P0.05）.Conclusion Compared with healthy controls，the expression of CD64 on the surface of peripheral blood lymphocytes and neutrophils in patients with CHB increased，but the expression of CD64 on the surface of peripheral blood lymphocytes and neutrophils decreased after interferon treatment，and the expression of CD64 on the surface of peripheral blood lymphocytes and neutrophils was positively correlated with HBsAg and ALT levels.Key words：immunoglobulin Fc gamma RI；lymphocyte；neutrophil；chronic hepatitis B；interferon-干扰素治疗慢性乙型肝炎（CHB，简称慢乙肝）较传统药物治疗有明显的优势，但仍有许多需要解决的问题，如缺少用于优势人群筛选、疗效评估以及预后评判的有效实验室指标等1。CD64（FcRI）是一种免疫球蛋白Fc受体的跨膜糖蛋白，可以高亲和力结合单体IgG型抗体，在细菌感染以及类风湿关节炎病患者外周血中性粒细胞表面表达上调，作为细菌感染性疾病的诊断指标在临床已被广为使用2-3。近年研究4-5发现，在巨细胞病毒以及 HBV等感染患者CD64的表达与健康人群不同，但CHB患者外周血细胞表面CD64表达量变化与干扰素治疗慢乙肝的疗效是否有关目前仍无文献报道。本研究通过比较干扰素治疗前后慢乙肝患者外周血不同亚群细胞表面 CD64表达量差异，分析干扰素治疗不同时间CHB患者外周血淋巴细胞和中性粒细胞表面CD64表达量与HBV-DNA、ALT、HBsAg的相关性，为下一步探讨外周血淋巴细胞和中性粒细胞表面CD64表达量是否能用于评估干扰素治疗效果提供参考资料。1 资料与方法 1.1临床资料收集 2018 年 6 月2021 年 3 月在成都市公共卫生临床医疗中心就诊的 CHB 患者 57 例，纳 入 标 准：ALT2 ULN、HBV-DNA2108 IU/mL、HBsAg定量0.05）。收集同期体检健康人员16例为对照组，男 10例、女 6例，年龄（34.7 12.2