HBV感染对日本血吸虫病患者肝纤维化的影响及Th1/Th2型细胞因子水平的变化  

Effects of HBV infection on hepatic fibrosis and level of Th1/Th2 cytokines in the patients with Schistosomiasis japonica

作　　者：贾中伟[1] 储德勇[2] 王维[2] 罗庆礼[2] 沈继龙[2] 

机构地区：[1]安徽医科大学第一附属医院检验科,合肥230032 [2]安徽医科大学病原生物学教研室

出　　处：《中华检验医学杂志》2007年第10期1105-1108,共4页Chinese Journal of Laboratory Medicine

基　　金：国家自然科学基金(30571631)

摘　　要：目的评估慢性日本血吸虫病患者血清中 Th1型[γ干扰素(IFN-γ)、肿瘤坏死因子α(TNF-α)]和 Th2型[白细胞介素(IL)-10、IL-13)]细胞因子水平,探讨晚期肝纤维化易感性与细胞因子水平的关系。方法358例晚期血吸虫病患者,采用 B 超对肝纤维化程度进行分级。随机选取HBsAg 阴性,早期肝纤维化患者39例,晚期肝纤维化患者29例。检测患者血清 IL-10、IL-13、IFN-γ、TNF-α的水平。结果358例患者 HBsAg 阳性率高达23.2%(83/358)。血吸虫病患者合并乙型肝炎感染较未感染者、晚期肝纤维化患者平均发病年龄并未提前,且构成比无明显差异(X^2=0.427,P=0.513)。晚期肝纤维化患者血清 IL-10水平[4.20(1.43～52.07)ng/L]高于早期肝纤维化患者[1.60(1.30～12.14)ng/L,z=-3.907,P<0.01];血清 IL-13水平[21.37(0.56～61.37)ng/L]显-著高于早期肝纤维化患者[12.94(3.37～26.99)ng/L,z=4.653,P<0.01];血清IFN-γ水平[3.12(1.38～66.14)ng/L]与早期肝纤维化患者[5.87(1.33～216.33)ng/L]比较差异无统计学意义(Z=-1.067,P>0.05);血清 TNF-α水平[2.48(0.79～19.86)ng/L]与早期肝纤维化患者血清TNF-α水平[2.28(0.67～15.72)ng/L]差异无统计学意义(Z=-0.112,P>0.05)。结论晚期血吸虫病患者中乙肝感染率高于全国平均水平。晚期肝纤维化的患者血清存在着高水平的 IL-13。Objective The levels of Thl cytokines （IL-10 and IL-13 ） and Th2 cytokines （INF-γ and TNF-α） were determined in the sera of patients with Schistosomiasis japonica in order to find the relationship between cytokines and severe hepatic fibrosis （HF） in schistosomiasis. Methods A total of 358 patients with advanced Schistosomiasis japonica were examined by ultrasound. 68 HBsAg negative patients were chosen randomly as experimental control. Among them, 39 patients were found to have mild HF and 29 were severe HF. The sera levels of Thl and Th2 cytokines were determined with ELISA. Results Among these 358 patients, 83 （23.2%） were HBsAg positive. Neither earlier nor severer hepatic fibrosis was noted in the patients who had been simultaneously infected with HHBV than those only infected with schistosomiasis. There was a significant difference between mild [ 1.60 （ 1.30 - 12. 14） ng/L] and severe [ 4. 20 （ 1.43 - 52.07 ） ng/L] I-IF patients in the level of IL-10（ Z = - 3. 907, P 〈 0.01 ）. The level of IL-13 in severe I-IF patients was [ 21.37 （0. 56 -61.37 ） ng/L], significantly higher （Z = -4. 653 ,P 〈 0.01 ） than that in mild HF patients [ 12. 94 （3.37 - 26. 99） ng/L]. Also the significant difference （ Z = - 1. 067, P 〉 0. 05 ） was found in level of IFN-γ between severe [3. 12（ 1.38 -66. 14） ng/L] and mild[5.87（ 1.33 -216. 33） ng/ L ] I-IF subjects. Our observation did not reveal any obvious difference of TNF-α between severe [ 2.48 （0. 79 - 19. 86） ng/L] and mild E 2. 28 （0. 67 - 15.72） ng/L] HF groups. Conclusions Patients infected with advanced shistosomiasis may become more susceptible to HBV. The results of the present investigation showed that a high level production of IL-13 was associated with severe HF.

关 键 词：细胞因子类 血吸虫 日本 肝硬化 

分 类 号：R512.6R532.2[医药卫生—内科学] R575.2[医药卫生—临床医学]