关键词: 慢性丙型肝炎, 淋巴细胞, T细胞, B细胞

Abstract: Objective To explore the characteristics and clinical significance of peripheral blood lymphocyte subsets in patients with chronic hepatitis C. Methods Between January 2018 and July 2022, 138 patients with chronic hepatitis C and 72 healthy persons admitted for physical examination in the same period were selected. According to their clinical manifestations, the patients were divided into simple chronic hepatitis C group, early hepatitis C cirrhosis group and decompensated hepatitis C. The general data, peripheral blood lymphocyte subsets count and peripheral blood lymphocyte subsets percentage were compared. Results Comparing the clinical features, the levels of ALT, AST, and total bilirubin were 29.6 (18.2, 47.8) U/L, 33.6 (24.4, 50.1) U/L and 25.5 (18.5, 63.6) μmol/L respectively, which were significantly higher than in control group (21.5 (16.8, 26.5) U/L, 23.5 (15.7, 30.2) U/L and 16.6 (13.6, 26.1) μmol/L) (P<0.05). While the level of Hb was 78.2 (64.2, 105.3) g/L, which was significantly lower than that of control group97.3 [ (78.1, 118.9) ] g/L. Comparing the number of lymphocyte subsets in peripheral blood, the absolute value of CD45⁺CD3⁺CD4⁺ lymphocytes, CD45⁺CD3⁺CD8⁺ lymphocytes, and CD45⁺CD3^-CD16⁺56⁺ lymphocytes of simple chronic hepatitis C group were 7058 (4612, 9645) /mL, 5739 (4015, 7462) /mL and 2694 (845, 3512) /mL respectively, which were significantly lower than that of control group [(7962 (5492, 9413) /mL, 6036 (4921, 9687) /mL and 3876 (1694, 4982) /mL)] (P<0.05). The absolute value of CD45⁺ lymphocytes, CD45⁺CD3⁺ lymphocytes, CD45⁺CD3⁺CD4⁺ lymphocytes, CD45⁺CD3⁺CD8⁺ lymphocytes and CD45⁺CD3^-CD16⁺56⁺ lymphocytes of hepatitis C early cirrhosis group were 1550 (1256, 1864) /mL, 1126 (826, 1569) /mL, 6342 (5169, 8945) /mL, 5897 (3958, 8521) /mL and 2730 (1398, 4851) /mL respectively, which were significantly lower than in control group [1900 (1659, 2506) /mL, 1420 (913, 1649) /mL, 7962 (5492, 9413) /mL, 6036 (4921, 9687) /mL and 3876 (1694, 4982) /mL] (P<0.05). The absolute value of CD45⁺ lymphocytes, CD45⁺CD3⁺ lymphocytes, CD45⁺CD3⁺CD4⁺ lymphocytes, CD45⁺CD3⁺CD8⁺ lymphocytes and CD45⁺CD3^-CD16⁺56⁺ lymphocytes of decompensated hepatitis C cirrhosis group were 1226 (854, 1695) /mL, 953 (562, 1654) /mL, 6095 (4951, 9165) /mL, 3964 (1652, 5984) /mL and 2465 (1245, 3451) /mL respectively, which were significantly lower than in control group [1900 (1659, 2506) /mL, 1420 (913, 1649) /mL, 7962 (5492, 9413) /mL, 6036 (4921, 9687) /mL and 3876 (1694, 4982) /mL] (P<0.05). Compared with the percentage of lymphocytes , the percentage of CD45⁺CD3^-CD19⁺ lymphocytes and CD4⁺/CD8⁺ of hepatitis C early cirrhosis group were 19.8 (9.6, 27.7) and 2.9 (1.4, 3.5), respectively, which were significantly higher than in control group [15.7 (7.5, 21.6) and 2.3 (1.6, 3.1)] (P<0.05). While the percentage of CD45⁺CD3^-CD16⁺56⁺ was 15.8 (6.6, 29.8), which was significantly lower than in control group [17.8 (8.6, 27.1)] (P<0.05). The percentage of CD45⁺CD3^-CD19⁺ and CD4⁺/CD8⁺ ratio of decompensated hepatitis C cirrhosis group were 21.5 (6.2, 30.3) and 3.1 (1.3, 4.1), respectively, which were significantly higher than in control group [15.7 (7.5, 21.6) and 2.3 (1.6, 3.1) ] (P<0.05). While the percentage of CD45⁺CD3^-CD16⁺56⁺ was 9.6 (3.3, 16.7), which was significantly lower than in control group [17.8 (8.6, 27.1)] (P<0.05). Conclusion During the chronic development of hepatitis C virus infection to the early stage and decompensated stage of liver cirrhosis, the absolute values of CD4⁺T cells, CD8⁺T cells and NK cells in peripheral blood decreased, while the percentage of B cells in the peripheral blood and CD4/CD8 ratio both significantly rised.

Key words: Chronic hepatitis C, Lymphocyte, T cell, B cell