肝病患者合并EB病毒感染的肝功能分析

Analysis of liver function in hepatopath co-infectied with Epstein-Barr virus

摘要:

目的：分析肝病患者合并EB病毒（Epstein-Barr virus，EBV）感染的肝功能表现，探讨EBV对肝病患者肝功损伤加重可能的机制。方法：收集EBV核酸（EBV-DNA）检测肝病患者244例，分析肝病患者中的EBV-DNA阳性率；按照HBsAg分组，分析EBV感染合并HBsAg+和HBsAg-肝病患者的肝功差异；选取HBsAg+（n=45）和HBsAg-（n=69）未知病因患者，流式细胞术分析EBV感染对外周血免疫细胞的影响；免疫组织化学评估EBV感染对肝病患者肝组织免疫细胞的影响。结果：EBV-DNA结果显示，244例肝病患者的EBV-DNA+检出率为29.91%，HBsAg-和HBsAg+肝病患者中，EBV+肝功能均比EBV-严重，其中HBsAg-中谷草转氨酶（aspartate aminotransferase，AST）、谷丙转氨酶（alanine aminotransferase，ALT）、总胆汁酸（total bile acids，TBA）增高明显（P<0.05），HBsAg+中AST、ALT、γ-谷氨酰转肽酶（γ-glutamyl transaminase，GGT）增高明显（P<0.01）。流式细胞术显示，EBV明显降低了HBsAg+与HBsAg-患者外周血和肝组织CD8+ T的比率；与HBsAg-相比，EBV明显降低了HBsAg+患者CD8+T细胞。结论：EBV对于肝病患者肝功能损伤加重明显，其可能机制是EBV对外周循环和肝组织免疫细胞CD8+T的消耗降低了机体对肝炎的抵抗所致。

Abstract:

Objective：To analyze the liver function manifestations of hepatopaths co-infectied with Epstein-Barr virus（EBV） and to explore the possible mechanism of EBV to aggravate liver function injury in hepatopaths. Methods：A total of 244 hepatopaths who screened by EBV nucleic acid detection，and the positive rate of EBV-DNA was determined. The patients were divided into groups by HBsAg，and the differences of liver function in patients with EBV infection complicated with HBsAg+ and HBsAg- liver disease were analyzed. Patients with unknown etiology of HBsAg+（n=45） and HBsAg-（n=69） were selected，and the influence of EBV infection on peripheral blood immune cells was analyzed by flow cytometry. Immunohistochemistry was used to evaluate the effect of EBV in－fection on immune cells in liver tissue of hepatopaths. Results：The detection rate of EBV-DNA+ in 244 cases of liver disease was 29.91%. In patients with HBsAg- and HBsAg+ liver injury，liver function of EBV+ was worse than that of EBV-，in which，aspartate aminotransferase（AST），alanine aminotransferase（ALT），and total bile acids（TBA） in patients with HBsAg- liver injury increased significantly（P<0.05）；AST，ALT，and γ-Glutamyl transaminase（γ-GGT） in patients with HBsAg+ liver injury increased significantly（P<0.01）. Flow cytometry showed that EBV significantly reduced the ratio of CD8+ T in peripheral blood and liver tissue between HBsAg- and HBsAg- patients. Compared with HBsAg-，EBV significantly reduced CD8+ T cells in HBsAg+ patients. Conclusion：EBV can aggravate liver function injury in hepatopaths，and the possible mechanism is that EBV consumes CD8+ T cells in peripheral circulation and liver tissue，which reduces the body’s resistance to hepatitis.