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目的 分析慢性乙型肝炎（chronic hepatitis B, CHB）患者血清中可溶性程序性死亡受体1(soluble programmed death 1, sPD-1)和可溶性程序性死亡配体1(soluble programmed death ligand 1, sPD-L1)的表达水平，探讨CHB患者发生低病毒血症（low-level viremia, LLV）的危险因素。方法 选取2024年10月至2025年5月在淄博市第一医院就诊的CHB患者190例，依据病毒学应答情况分为LLV组和持续病毒学应答（sustained virologic response, SVR）组。应用酶联免疫吸附试验试剂盒检测血清中sPD-1和sPD-L1的水平。采用Spearman秩相关分析评估sPD-1与sPD-L1水平的相关性，以及二者分别与肝功能血清学指标的相关性。比较不同乙型肝炎表面抗原（hepatitis B surface antigen,HBsAg）定量水平、乙型肝炎e抗原（hepatitis B e antigen, HBeAg）状态及病毒学应答分组间sPD-1与sPD-L1的表达差异。采用多因素Logistic回归分析探讨CHB患者发生LLV的独立危险因素。结果 CHB患者sPD-1与sPD-L1水平呈中度正相关，sPD-L1水平与log HBsAg定量亦呈中度正相关（均P<0.05）。HBsAg定量>1 000 IU/mL组sPD-1和sPD-L1水平显著高于HBsAg定量≤1 000 IU/mL组，HBeAg阳性组sPD-1和sPD-L1水平显著高于HBeAg阴性组（均P<0.05）。LLV组sPD-1和sPD-L1水平显著高于SVR组（均P<0.05）。多因素Logistic回归分析提示HBeAg阳性、log HBsAg水平和sPD-1水平是CHB患者发生LLV的独立危险因素（均P<0.05）。结论 CHB患者血清中sPD-1和sPD-L1的表达呈正相关，HBeAg阳性、log HBsAg水平和sPD-1水平是CHB患者发生LLV的独立危险因素，sPD-1和sPD-L1可能参与了CHB患者乙型肝炎病毒持续存在的免疫调控过程。
Abstract：Objective To analyze the expression levels of soluble programmed death-1(sPD-1) and soluble programmed death-ligand 1(sPD-L1) in the serum of patients with chronic hepatitis B(CHB), and to identify independent risk factors for low-level viremia(LLV). Methods A total of 190 CHB patients admitted to Zibo First Hospital between October 2024 and May 2025 were enrolled and classified into an LLV group or a sustained virologic response(SVR) group based on virological response status. Serum levels of sPD-1 and sPD-L1 were determined by enzyme-linked immunosorbent assay(ELISA) kits. Spearman rank correlation was used to assess the correlation between sPD-1 and sPD-L1 levels, as well as their respective correlations with liver-function serological markers. The expression differences of sPD-1 and sPD-L1 were compared across groups based on hepatitis B surface antigen(HBsAg) quantification, hepatitis B e antigen(HBeAg) status, and virological response categories. Multivariate logistic regression analysis was performed to identify independent risk factors of LLV in CHB patients. Results Serum levels of sPD-1 and sPD-L1 in CHB patients showed a moderate positive correlation, and sPD-L1 levels were also moderately positively correlated with log HBsAg quantification(P<0.05). The sPD-1 and sPD-L1 levels in the group with HBsAg quantification >1 000 IU/mL were significantly higher than those in the group with HBsAg quantification ≤1 000 IU/mL, and the sPD-1 and sPD-L1 levels in the HBeAg-positive group were significantly higher than those in the HBeAg-negative group(P<0.05). The sPD-1 and sPD-L1 levels in the LLV group were significantly higher than those in the SVR group(P<0.05). Multivariate logistic regression analysis indicated that HBeAg positivity, log HBsAg level, and sPD-1 level as independent risk factors for LLV in CHB patients(P<0.05). Conclusion The expression levels of sPD-1 and sPD-L1 in the serum of CHB patients are positively correlated. HBeAg positivity, log HBsAg level, and sPD-1 level are independent risk factors for the development of hepatitis B virus LLV in CHB patients. sPD-1 and sPD-L1 may be involved in the immune regulatory processes underlying the persistence of hepatitis B virus in CHB patients.
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基本信息:
中图分类号:R512.62
引用信息:
[1]刘宇,吕承秀,孙晓琳,等.慢性乙型肝炎患者血清sPD-1和sPD-L1的表达水平及其发生低病毒血症的危险因素分析[J].传染病信息,2026,39(03):233-237.
基金信息:
山东第二医科大学附属医院科技发展项目（2023FYZ005）; 淄博市医药卫生科技项目（20241801118）
2026-06-30
2026-06-30