目的 探讨在HBV相关性疾病不同严重程度的患者其外周血中CD27+B细胞百分率的变化情况以及在临床中代表的意 义。方法 选择2016年2月至2017年2月期间在我院就诊的20例慢性乙型肝炎患者、23例乙肝相关性肝硬化患者、21 例乙肝相关性肝癌患者作为研究对象，同时取同时期的25例健康志愿者作为对照组，对比健康志愿者和患者之间的 细胞免疫中CD27+ B细胞百分率、体液免疫中IgM、IgD的表达情况。结果 在CD27+ B细胞百分率对比中，健康志愿者为 (5.17±0.38)%，慢乙肝患者为(4.53±0.21)%，肝硬化患者为(2.23±0.12)%，肝癌患者仅为(0.55±0.04)%，发现 三组患者的CD27+ B细胞百分率要明显低于对照组(P＜0.05)，同时随着疾病的严重程度，CD27+ B细胞百分率下降的比 例也越高。在IgM、IgD的表达情况对比中，发现三组HBV相关性疾病患者中，其IgM、IgD水平的表达要明显上升并 高于对照组(P＜0.05)，同时疾病程度越严重，IgM、IgD上升的幅度也越高。结论 在HBV相关性疾病中，患者疾病 程度越严重，其外周血中的CD27+B细胞比例越低，而IgM、IgD的表达水平越高，预示着CD27+ B细胞和此类患者有密 切联系，可以通过对CD27+ B细胞水平的监测来评估患者机体免疫系统能力，为临床治疗提供指导意见。

Objective To explore the clinical significance of peripheral blood CD27+B cell percentage in patients with different HBV-related disease progressions. Methods 20 patients with chronic hepatitis B, 23 patients with hepatitis Bassociated liver cirrhosis and 21 patients with hepatitis B-related hepatocellular carcinoma treated from February 2016 to February 2017 in our hospital were selected. 25 healthy check-ups were selected as control group. The CD27+ B cell percentage as well as IgM and IgD expression of humoral immunity for each group was compared. Results Based on the TCD27+ B cell percentage, the healthy check-ups accounted for (5.17±0.38)%, the chronic hepatitis B patients for (4.53±0.21)%, hepatitis B- associated liver cirrhosis patients for (2.23±0.12)% and the hepatitis B-related hepatocellular carcinoma patients for (0.55±0.04)%, it was known that the CD27+ B cell percentage for the HBV-related patients were significantly lower than control group (P<0.05), the severer the disease was, the lower the CD27+ B cell percentage was; the expression of IgM and IgD for HBV-related patients were significantly higher than control group (P<0.05), the severer the disease was, the higher the IgM and IgD expression was. Conclusion With the severer HBV-related disease,the CD27+ B cell percentage is lower while the IgM and IgD expression is higher, which it indicates the CD27+ B cells have a close correlation with the HBV-related patients. The monitoring of CD27+ B cell is used to evaluate the patient’s immune system and provide the treatment guidance in clinical practice.