重型乙型肝炎患者血清干扰素诱导蛋白-10、干扰素γ的检测及临床意义  

Detection and clinical significance of serum interferon-inducible protein-10 and interferon-γ in patients with severe hepatitis B

作　　者：罗亚文[1] 罗军敏[2] 林世德[1] 易学东[3] 

机构地区：[1]遵义医学院附属医院感染科,贵州遵义563003 [2]遵义医学院附属医院免疫学教研室,贵州遵义563003 [3]遵义医学院附属医院药剂科,贵州遵义563003

出　　处：《中华传染病杂志》2008年第4期244-247,共4页Chinese Journal of Infectious Diseases

摘　　要：目的探讨干扰素诱导蛋白-10（IP-10）、IFN-γ与重型乙型肝炎（SHB）患者肝脏炎性反应程度及病情发展的关系。方法采集40例SHB患者入院时、单次血浆置换（PE）开始、PE结束及PE后5d血清，根据SHB患者PE后5d病情转归分为好转组及恶化组；采集20例慢性乙型肝炎（CHB）患者及20例健康对照组血清；双抗体夹心ELISA法检测血清IP-10、IFN-γ、TNF-α水平。结果入院时，SHB及CHB组患者血清IP-10水平分别为（683．6±174．6）、（216．1±102．9）ng／L，均高于健康对照组的（107．6±55．8）ng／L（F=9．036，P〈0．01），且SHB组高于CHB组（P〈0．01）；SHB及CHB组患者血清IFN-γ水平分别为（19．8±8．8）、（16．7±7．8）ng／L，均高于健康对照组的（2．6±1．2）ng／L（F=9．288，P〈0．01）；SHB患者IP-10、IFN-γ与TNF-α均呈正相关（r=0．366，r=0．365；P〈0．05），与凝血酶原活动度呈负相关（r=0．401，r=0．350；P〈0．05），与血清TBil相关性不明显（r=0．223，r=0．219；P〉0．05），IP-10与IFN-γ呈正相关（r=0．602；P=0．000）。PE后5d，SHB两组患者血清IP-10均明显下降（t=8．947，P〈0．01；t=4．121，P〈0．05），恶化组高于好转组（t=7．862，P=0．01），IFN-γ下降均不明显（t=0．491，P〉0．05）。结论IPL-10、IFN-γ参与SHB的肝脏免疫损伤；血清IP-10水平与肝脏炎性损害程度有关；IP-10能反映SHB患者病情发展及转归。Objective To explore the relationship between serum levels of interferon-inducible protein-10（IP-10）, interferon-γ（IFN-γ） and hepatic inflammatory reaction, disease progression in patients with severe hepatitis B （SHB）. Methods Sera of 40 patients with SHB at time of admission, at the beginning of single plasma exchange （PE）, at time of PE completion and 5 days after PE. The SHB patients were divided into improved group and aggravated group. And 20 patients with chronic hepatitis B （CHB） and 20 healthy controls were enrolled in this study. Serum levels of IP-10, IFN-γ and tumor necrosis factor-α（TNF-α） were determined by enzyme-linked immunosorbent assay （ELISA）. Results The serum levels of IP-10 in patients with SHB and CHB on admission were （683.6±174.6）ng/L and （216.1±102.9）ng/L, respectively, which were notably higher than those in healthy controls [（107.6±55.8）ng/L F=9.036, both P〈0.01], and those in patients with SHB was significantly higher than that in patients with CHB （P〈0. 01）. The serum level of IFN-7 in patients with SHB and CHB on admission were （19. 8±8.8） ng/L and （16.7±7.8） ng/L, respectively, which were significantly higher than those in healthy controls [（2.6＋ 1.2） ng/L F=9. 288, both P〈0.011. The serum level of IP-10 and IFN-γ were both positively correlated with TNF-α（r=0. 366 and r=0. 365, respectively; P〈0.05） and both negatively correlated with prothrombinase activity （r=-0.401 and r=-0.350, respectively;P〈0.05）, but not correlated with serum total bilirubin（r=0. 223 and r=0. 219, respectively;P〉0.05）. The serum level of IP-10 and IFN-γ were positively correlated （r=0. 602 ,P= 0. 000）. On day 5 after PE, serum level of IP-10 in patients with SHB was significantly decreased compared with that in patients before PE （t= 8. 947, P〈0.01 in improved group; t=4. 121, P〈0.05 in aggravated group） and that in aggravated group was significantly higher than improved group （t= 7. 862, P〉0.01�

关 键 词：肝炎 乙型 干扰素诱导蛋白10 干扰素Ⅱ型 血浆置换 

分 类 号：R512.62[医药卫生—内科学]