【摘要】目的 了解慢性乙型肝炎血液透析患者（hemodialysis patient with chronic hepatitis B,CHB-HD）T淋巴细胞亚群（T-lymphocytes）的变化及其影响因素。方法 以43例慢性乙型肝炎血液透析（CHB-HD）患者为研究对象，以46例普通血液透析（HD）患者作为对照，应用单克隆抗体流式细胞术检测CD3+、CD4+、CD8+T淋巴细胞计数，CD4+/CD8+比值，检测血生化指标、全段甲状旁腺激素（iPTH），超敏C反应蛋白（hs-CRP），白细胞（WBC），血红蛋白（HB）。比较CHB-HD与HD患者T淋巴细胞亚群及其他生化指标的差异，并分析CHB-HD患者T淋巴细胞亚群的变化及可能的影响因素。结果 CHB-HD与HD患者相比，CD3+T淋巴细胞计数降低（883.12±331.74 / mm3 vs 1060.94±337.01 / mm3，P＜0.05）；CD8+T淋巴细胞计数降低（336.65 ±153.95 / mm3 vs 441.89±209.76 / mm3, P＜0.05）。在CHB-HD患者中，白蛋白（ALB）与 CD3+、CD8+T淋巴细胞计数正相关，相关系数分别为0.298（P=0.048），0.314（P=0.041）。前白蛋白（PALB）与CD3+、CD8+ T淋巴细胞计数正相关，相关系数分别为0.370（P=0.029），0.391（P=0.020）。结论 慢性乙型肝炎血液透析患者T淋巴细胞紊乱进一步加重，并与前白蛋白水平相关。

【Abstract】Objective To investigate the alteration of T-lymphocyte subsets in hemodialysis patients with chronic hepatitis B (CHB-HD) and its influencing factor. Methods Two groups of patients were included for investigation: 43 HD patients with CHB (CHB-HD group) as study group, and 46 HD patients with non-CHB (HD group) as control group. T-lymphocyte subsets were measured by flow cytometry. Biochemical parameters, hs-CRP and iPTH were also measured. The differences between two groups were analyzed and influencing factors of T-lymphocyte subsets in CHB-HD patients were determined. Results Compared with ordinary HD patients, the alteration of T-lymphocyte subsets in CHB-HD patients were mark: CD3+T-lymphocytes were greatly reduced（883.12±331.74 / mm3 vs 1060.94±337.01 / mm3, P＜0.05）;CD8+ T-lymphocytes were also dramatically decreased（336.65±153.95 / mm3 vs 441.89±209.76 / mm3, P＜0.05. Pearson correlation analysis showed that the count of CD3+,CD8+ T-lymphocyte and the level of PALB were positively correlated. Conclusion The disorders of T-lymphocyte subsets in hemodialysis patients with chronic hepatitis B were further aggravated than ordinary hemodialysis patients, and the levels of ALB and PALB maybe positively correlated with these change