慢性重型肝炎患者乙型肝炎病毒C基因启动子变异与病毒载量及细胞因子的关系  

Relationship between HBV BCP mutation and serum HBV DNA contents as well as cytokines in chronic fulminant hepatitis B patients

作　　者：黄力毅[1] 玉艳红[1] 吴继周[1] 宣伟军[2] 

机构地区：[1]广西医科大学第一附属医院感染性疾病科,广西南宁530021 [2]广西中医学院,广西南宁530001

出　　处：《临床荟萃》2007年第6期381-384,共4页Clinical Focus

基　　金：广西科学基金项目(桂科自0339050);广西卫生厅课题(桂卫Z2004127)

摘　　要：目的研究慢性重型肝炎患者乙型肝炎病毒C基因启动子(HBV BCP)变异与病毒载量(HBV DNA)及细胞因子关系。方法采用聚合酶链反应(PCR)微板核酸杂交结合酶联免疫吸附测定(ELISA)检测显示技术,对156例HBV慢性感染者(慢性乙型病毒性肝炎轻、中、重度,肝炎肝硬化和慢性重型肝炎)血清进行检测HBV BCP区核苷酸(nt)1 762碱基A^T和1 764G^A联合突变的检测。采用PCR结合荧光探针检测技术,检测患者血清HBV DNA含量;采用双抗体夹心ELISA检测技术,检测患者血清细胞因子[白细胞介素10(IL-10)、白细胞介素12(IL-12)、肿瘤坏死因子α(TNF-α)和γ干扰素(IFN-γ)]水平。结果HBV BCP变异在慢性重型肝炎组的阳性率为60.0%(15/25)显著高于非重型肝炎组的33.6%(44/131)(P=0.023);慢性重型肝炎组HBV DNA含量(107.3731±1.4381copies/ml)与非慢性重型肝炎组HBV DNA含量(106.6516±1.8046copies/ml)比较差异无统计学意义(P>0.05);慢性重型肝炎组与非慢性重型肝炎组血清IL-10和IFN-γ比较差异无统计学意义[(82.80±28.19)ng/L vs(74.60±26.87)ng/L,(22.00±16.41)ng/L vs(16.85±9.41)ng/L](均P>0.05),慢性重型肝炎组的血清IL-12和TNF-α水平明显高于非慢性重型肝炎组[(49.04±15.10)ng/L vs(36.81±14.41)ng/L,(60.68±30.83)ng/L vs(38.89±13.52)ng/L](均P<0.01)。结论HBV BCP变异与慢性重型肝炎关系密切,HBV DNA复制水平在慢性重型肝炎的发生中可能只起到启动的作用;细胞因子IL-12和TNF-α在慢性重型肝炎的发生中可能起主要的作用。Objective To investigate the relationship between HBV BCP mutation and serum HBV DNA contents as well as cytokines in chronic fulminant patients.Methods A total of 156 patients,chronic hepatitis B(mild,moderate and severe degree;liver cirrhosis and chronic fulminant hepatitis B virus infection) were studied.The A to T mutation at nucleotide 1 762 and G to A mutation at nucleotide 1 764 were determined by the method of polymerase chain reaction(PCR) microplate hybridization ELISA in these patients.Serum HBV DNA of these patients was detected by fluorescence PCR.The serum cytokines(IL-10,IL-12,TNF-α and IFN-γ) of these patients were measured by specific-ELISA.Results The positive rate of mutants in chronic fulminant hepatitis and in non-fulminant groups was 70.0%(15/25) and 33.6%(44/131),respectively(P=0.023).There was no significant difference in the serum levels of HBV DNA between the group of chronic fulminant hepatitis B(107.3731±1.4381copies/ml) and the non-fulminant group(106.6516±1.8046copies/ml).There was no significant difference between chronic fulminant hepatitis B and non-fulminant group in the serum levels of IL-10 and IFN-γ [(82.80±28.19) ng/L vs(74.60±26.87) ng/L,(22.00±16.41) ng/L vs(16.85±9.41) ng/L](all P>0.05).The serum levels of IL-12 and TNF-α in chronic fulminant hepatitis B group were significantly higher than those in non-fulminant group [(49.04±15.10) ng/L vs(36.81±14.41) ng/L,(60.68±30.83) ng/L vs(38.89±13.52) ng/L](all P<0.01).Conclusion The mutation in BCP region might be correlated to the occurrence of chronic fulminant hepatitis.The serum levels of HBV DNA might have a minor effect on the development chronic fulminant hepatitis B. The serum levels of IL-12 and TNF-α might have an important role in developing chronic fulminant hepatitis B.

关 键 词：肝炎 慢性 肝炎病毒 乙型 基因变异* 白细胞介素-12 肿瘤坏死因子α 

分 类 号：R575.1[医药卫生—消化系统]