| Objective:By analyzing the relationship between the level characteristics of peripheralbl ood T lymphocyte subsets in patients with chronic HBV infection at differentclinical stages and various clinical indicators,and at the same time,follow-up patients with immune tolerance and e antigen-positive patients to evaluate T ly-mphocyte subsets The diagnostic efficacy of immune status,breaking immuneto-lerance and e-antigen conversion,and exploring the distribution characteristicsa-nd clinical significance of T lymphocyte subsets in patients with chronic HBVinfection.Methods:A total of 231 patients with chronic HBV infection were admitted and hos-pitalized in the Department of Infectious Diseases of the First Affiliated Hospital of Nanchang University from December 2018 to December 2020.Basic dat-a and various clinical index values were collected,based on immune status an-d HBV-DNA load,HBs Ag quantitative level to group,observe the relationship between T lymphocyte subsets and various clinical indicators and evaluate the diagnostic efficacy of immune status;at the same time 55 cases of chronic HB-V infection in the immune tolerance stage and 132 cases of HBe Ag(+)positi-ve patients Follow-up to observe the diagnostic efficacy of T lymphocyte subs-ets for breaking immune tolerance and e-antigen seroconversion and the chang-es inperipheral blood T lymphocyte subsets of patients with chronic HBV infe-ction before and after anti-virus.Results:1.After HBV infection,the absolute value of CD3~+,CD4~+,CD8~+cells and the CD4/CD8 ratio between the immune tolerance group and the non-immune tolerance group were lower than the healthy physical examination group,and the difference was statistically significant(P<0.05).The absolute value of CD3~+and CD4~+cells,the ratio of CD4~+cells and the ratio of CD4/CD8 in the immune tolerance group were lower than those in the non-immune tolerance group,and the difference was statistically significant(P<0.05).2.The absolute value and ratio of CD3~+and CD4~+cells in the peripheral blood of patients with chronic HBV infection,and the ratio of CD4/CD8 showed a gradual decrease with the increase of HBV load,the absolute value and ratio of CD8~+cells gradually increased significantly,the difference was statistically significant(P<0.05).3.In patients with chronic HBV infection,the absolute values of CD3~+,CD4~+cells in the HBs Ag quantitative high-load group are lower than those in the low and medium HBs Ag-load groups,and the difference in the absolute values of CD3~+and CD4~+cells is statistically significant(P<0.05).low load The ratio of CD4/CD8 in the medium-load group was greater than that in the medium-load group,and the difference was statistically significant(P<0.05).4.There is a negative correlation between the absolute value and ratio of HBV-DNA and CD3~+cells,the ratio of CD4~+cells,and the ratio of CD4/CD8,the correlation coefficients are-0.407,-0.438,-0.516,-0.703,and there is a positive correlation with the ratio of CD8~+cells,The correlation coefficient is 0.511.HBs Ag has a negative correlation with the absolute value of CD3+cells and the absolute value of CD4~+cells,and the correlation coefficients are-0.431 and-0.429,respectively.There is a negative correlation between ALT and the absolute value and proportion of CD8~+cells,and the correlation coefficients are-0.418 and-0.439,respectively.TBi L has a negative correlation with the absolute value and ratio of CD3~+cells,the absolute value and ratio of CD4~+cells,and the absolute value and ratio of CD8~+cells.The correlation coefficients are-0.443,-0.531,-0.572,-0.515,-0.453,-0.412,respectively.There is a positive correlation between WBC count and absolute value of CD3~+cells,absolute value of CD4~+cells,and absolute value of CD8~+cells,and the correlation coefficients are 0.486,0.438,0.409,respectively.5.After antiviral treatment,the absolute value and ratio of CD3~+cells,the absolute value and ratio of CD4~+cells,and the absolute value of CD8~+cells in patients with chronic HBV infection were significantly higher than before antiviral treatment,and the difference was statistically significant(P<0.05).6.The area under the curve of the absolute value of CD4~+cells,the ratio of CD4~+cells,and the ratio of CD4/CD8 to assess the immune status are 0.774,0.827,0.721,respectively.7.The area under the curve of the number of CD3~+,CD4~+,CD8~+cells and the ratio of CD4/CD8 for breaking the immune tolerance state is 0.831,0.892,0.802,0.837,respectively.8.The area under the curve of the number of CD3~+,CD4~+,and CD8~+cells for the detection efficiency of e-antigen conversion is 0.858,0.872,0.735,respectively.Conclusions:1.After HBV infection,cellular immune function declines and immune disorders are common.This phenomenon is more obvious in patients with immune tolerance.And as chronic hepatitis B disease becomes severe,the body’s cellular immune function may decline or even The phenomenon of exhaustion.2.There is a close relationship between HBV-DNA load,HBs Ag quantitative level and peripheral blood T lymphocyte subsets.The higher the HBV-DNA and HBs Ag load,the stronger the inhibitory effect on the patient’s cellular immune function,and antiviral therapy It can significantly improve the inhibitory effect of HBV-DNA on the patient’s cellular immune function.3.The absolute number and ratio of CD4~+cells and the ratio of CD4/CD8 have a good effect on evaluating the immune status of patients with HBV infection.The number of CD3~+,CD4~+,CD8~+cells and the ratio of CD4/CD8 can predict immune tolerance in patients with immune tolerance The status has a certain reference value,and the dynamic detection of peripheral blood T lymphocytes can be used to assist in evaluating the patient’s immune status and the possibility of breaking the immune tolerance.4.The detection of the number of CD3~+,CD4~+,CD8~+cells has certain reference significance for predicting the occurrence of e-antigen serological conversion. |
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