静脉药瘾者肝炎病毒流行病学及T_H细胞功能的研究  

RESEARCH ON EPIDEMIOLOGY OF HEPATITIS VIRUSES AND T_H LYMPHOCYTE RESPONSE AMONG INTRAVENOUS DRUG USERS

作　　者：张徐凯[1] 李建蓉[1] 王晶[2] 田昆仑[2] 王一心[2] 郭利军[2] 

机构地区：[1]华中科技大学同济医学院病原生物系,武汉430030 [2]大理学院病原生物学实验室

出　　处：《现代预防医学》2007年第12期2204-2206,2208,共4页Modern Preventive Medicine

基　　金：国家自然科学基金资助项目(30160083)

摘　　要：[目的]探讨静脉药瘾者血源性肝炎病毒(HBV,HCV,HDV,HGV)的流行病学情况,以及TH细胞因子变化与病毒感染的关系。[方法]收集406例静脉药瘾者和102例健康体检者静脉血,采用酶联免疫吸附法和荧光定量PCR检测HBV、HCV、HDV和HGV的感染状况,病毒感染阳性者同时进行血清丙胺酸转氨酶(ALT)检测。并对同一标本用酶联免疫吸附法、放射免疫法检测外周血单个核细胞诱生的IFN-γ和IL-4,血清中IL-2和IL-4水平。[结果]静脉药瘾者HBV、HCV、HDV和HGV的感染率分别是36.45%、69.7%、2.22%和1.97%,HBV和HCV的重叠感染人数为113人(27.83%)。对照组仅发现存在HBV感染(17.65%),其余病毒感染指标均为阴性,两者差异有统计学意义(P﹤0.05)。静脉药瘾者单个核细胞诱生的IFN-γ、IL-4以及血清IL-2比对照组减低;血清IL-4增高,差异有统计学意义(P﹤0.01),ALT异常者其血清IL-4明显增高。静脉药瘾者发生HBV和HCV感染时,单个核细胞诱生的IFN-γ进一步降低。[结论]静脉药瘾者血源性肝炎病毒主要是HBV和HCV,其TH细胞因子分泌减少,TH1和TH2细胞平衡紊乱,而肝炎病毒感染可进一步降低TH1产生IFN-γ水平,异常ALT是导致血清IL-4升高的因素。[Objective] To investigate the epidenfiologic features of blood-borue hepatitis viruses including hepatitis B virus （HBV）, hepatitis C virus （HCV）, hepatitis D virus （HDV） and hepatitis G virus （HGV） in Intravenous Drug Users （IVDU）, and to explore the relationship betweell TH lymphocyte cytokine and hepatitis infection. [Methods] Vefious blood of 406 IVDU and 102 healthy persons wei＇e collected. HBV-DNA and HCV-RNA were detected by Fluorescence Quantitative Polymerase Chain Reaction （FQ-PCR） . HBsAg, HBeAg, anti-HBc, anti-HCV, HDV-Ag and anti-HGV were assayed by ELISA. And the levels of alanme aminotransferase （ALT） were assayed in the sanlples of hepatitis viruses infection positive, the levels of cytokines of TH1 and TH2 were measm＇ed by ELISA. [ Results] The infection rate of IVDU was 36.45% for HBV, 69.7% for HCV, 2.22% for HDV and 1.97% for HGV, respectively. And the co-infection of HBV and HCV was detected in 113 IVDU （27.83%） . While for healthy persons, there was only HBV infection accounting for 17.65%. Compared with healthy persons, the levels of PHA-induced cytokines （IFN-γ and IL-4） and the level of serum IL-2 obviously decreased in IVDU （P 〈 0.01）, while the level of serum IL-4 significantly increased （P 〈 0.01 ） . Abnormal ALT was markedly relative to high level of serum IL-4. The IFN-γ level continuously decreased when the IVDU were infected with HBV/HCV. [Conclusions] HBV and HCV infection are common in the population of IVDU, which leads to high incidence of impaired THl response. ALT alteration is the reason for the high level of serum IL-4.

关 键 词：肝炎病毒 静脉药瘾者 细胞因子 流行病学 

分 类 号：R181.36[医药卫生—流行病学]