IL-18与HBV感染及拉米夫定治疗的相关性  

Relationship of IL-18 levels, HBV infection, and Lamivudine treatment in chronic hepatitis B

作　　者：张文坚[1] 万克青[1] 龚环宇[1] 张浩晔[1] 

机构地区：[1]中南大学湘雅三医院感染科,湖南长沙410013

出　　处：《中国现代医学杂志》2008年第7期952-955,共4页China Journal of Modern Medicine

摘　　要：目的探讨IL-18在HBV感染中的作用及其与拉米夫定治疗疗效的关系。方法应用ELISA法检测50例HBV感染者(无症状携带者15例,慢性肝炎21例,重型肝炎14例)及10例正常对照者的血清IL-18水平,并动态监测慢性乙型肝炎(CHB)患者在拉米夫定治疗期间血清IL-18水平的变化。结果不同临床类型HBV感染者之间IL-18水平具差异有显著性(P<0.01),病情愈重,水平愈高;CHB患者IL-18水平与ALT水平呈正相关(r=0.662,P=0.001);不同HBV DNA含量的CHB患者IL-18水平差异具有显著性(P<0.01),低病毒量组高于高病毒量组;在拉米夫定治疗过程中,HBV DNA转阴组IL-18水平在治疗后3个月较治疗前显著升高(P<0.05),在治疗后12月较治疗前显著降低(P<0.01),HBV DNA未转阴组IL-18水平无明显变化。结论IL-18可能参与了乙型肝炎的肝脏炎性损伤和HBV免疫清除过程,拉米夫定治疗可能增强Th1型细胞应答。[Objective] To evaluate the possible roles of IL-18 in HBV infection, and investigate the relationship between IL-18 and the result of lamivudine treatment. [Methods] 50 patients infected with HBV （including 15 cases of asymptomatic carriers, 21 cases of chronic hepatitis, and 14 cases of severe hepatitis） and 10 healthy individuals （as normal controls） were chosen to detect their serum levels of IL-18 by ELISA method. Patients with CHB were also detected during Lamivudine treatment. [Results] There were significant differences in serum IL-18 level between every 2 types of HBV infection （P 〈0.01）, the IL-18 level in patients with severe hepatitis was significantly higher than that in normal controls （P 〈0.01）. Almost no difference existed between chronic hepatitis and normal controls （P 〉 0.05）. The IL-18 level in asymptomatic carriers was lower than that in normal controls （P〈0.05）. There was a positive correlation between the levels of IL-18 and ALT in patients with CHB （r =0.662, P =0.001）. Significant difference appeared in serum IL-18 levels between patients with different amounts of HBV DNA, the IL-18 level of low amounts of HBV DNA being higher. In the course of lamivudine treatment, the IL-18 level in the group of HBV DNA negative conversion rose drastically three months after the treatment （P 〈0.05） and fell significantly twelve months later （P〈0.01）, compared with those without any treatment. [Conclusion] IL-18 may involve in the process of liver inflammatory injury and HBV immuno-elimination in patients with HBV infection. Lamivudine treatment can promote Thl immune responses.

关 键 词：肝炎 乙型 慢性 IL-18 拉米夫定 

分 类 号：R392.11[医药卫生—免疫学] R512.62[医药卫生—基础医学]