内科

目的检测慢性乙型肝炎病毒（HBV）感染者外周血CD8+ T细胞中Mg2+水平以及其表面活性抑制分子PD-1、CD95和活化分子CD38、NKG2D的表达情况，为HBV的临床治疗提供理论依据。方法选取2016年1月至2017年2月在我院肝病门诊就诊的未经抗病毒治疗的HBV感染患者62例及健康对照者30例为研究对象，根据外周血HBV DNA水平将HBV感染患者分为高病毒载量组和低病毒载量组。检测HBV感染患者及健康对照者外周血及CD8+ T细胞内Mg2+浓度，采用流式细胞术检测三组对象CD8+ T细胞表面分子PD-1、CD95、CD38和NKG2D的表达水平。结果HBV感染患者及健康对照者外周血Mg2+浓度比较差异无统计学意义（P＞0.05）；慢性HBV感染者CD8+ T细胞中Mg2+浓度显著低于健康对照者（P＜0.05），高病毒载量组患者CD8+ T细胞中Mg2+浓度显著低于低病毒载量组（P＜0.05）。HBV感染患者CD8+ T细胞表面分子PD-1表达水平显著高于健康对照者，高病毒载量组患者PD-1的表达水平显著高于低病毒载量组（P＜0.05）；高病毒载量组患者CD95表达水平显著高于低病毒载量组和健康对照组（P＜0.05），低病毒载量组与健康对照组CD95表达水平比较差异无统计学意义（P＞0.05）；高病毒载量组患者CD38表达水平显著低于低病毒载量组和健康对照组（P＜0.05），低病毒载量组与健康对照组CD38表达水平比较差异无统计学意义（P＞0.05）。HBV感染患者NKG2D表达水平显著低于健康对照者（P＜0.05），高病毒载量组患者NKG2D表达水平显著低于低病毒载量组（P＜0.05）。结论HBV感染者外周血CD8+ T细胞内Mg2+浓度下降可能与CD8+ T细胞功能耗竭存在一定的关联，可能与Mg2+转运体功能异常有关。

ObjectiveTo detect the level of Mg2+ in peripheral blood CD8+ T cells of of patients with chronic hepatitis B virus (HBV) infection, and to detect the expression of CD8+ T cells′ surface active inhibitory molecules PD-1, CD95 and activation molecules CD38 and NKG2D, so as to provide theoretical basis for the clinical treatment of HBV. Methods62 cases of HBV infection without antiviral treatment and 30 healthy controls were selected who were treated in the clinic of the liver disease clinic in our hospital from January 2016 to February 2017. HBV infected patients were divided into high viral load group and low viral load group according to the level of HBV DNA in peripheral blood. The concentration of Mg2+ in peripheral blood and CD8+ T cells in patients with HBV infection and healthy controls was detected. Flow cytometry was used to detect the expression level of PD-1, CD95, CD38 and NKG2D on the surface molecules of CD8+ T cells in three groups of objects. ResultsThere was no significant difference in the concentration of Mg2+ in the peripheral blood of the HBV infected patients and the healthy controls (P＞0.05). The concentration of Mg2+ in CD8+ T cells of patients with chronic HBV infection was lower than that in the healthy control group (P＜0.05). The concentration of Mg2+ in CD8+ T cells of the high virus load group was lower than that of low viral load group (P＜0.05). The surface molecular PD-1 expression level of CD8+ T cells in patients with HBV infection was higher than that of healthy controls. The expression level of PD-1 in the high viral load group was higher than that in the low viral load group (P＜0.05). The expression level of CD95 in the high viral load group was higher than that in the low viral load group and the healthy control group (P＜0.05). There was no significant difference in the level of CD95 expression between the low viral load group and the healthy control group (P＞0.05). The expression level of CD38 in the high viral load group was lower than that in the low viral load group and the healthy control group (P＜0.05). There was no significant difference in the level of CD38 expression between the low viral load group and the healthy control group (P＞0.05). The expression of NKG2D in HBV infected patients was lower than that of healthy controls (P＜0.05). The expression level of NKG2D in the high viral load was lower than that in the low viral load group (P＜0.05). ConclusionThere may be a correlation between the decrease of Mg2+ concentration in the CD8+ T cells of peripheral blood and the depletion of CD8+ T cells in the peripheral blood of HBV infected people. It may be related to the abnormal function of the Mg2+ transporter.