核苷类似物早期病毒学应答慢性乙型肝炎患者血清sTRAIL水平变化及意义  

The study of the sera TRAIL levels in chronic hepatitis B patients treated with Nucleoside analogues

作　　者：魏屏[1] 王华[2] 曾令兰[2] 朱励[3] 

机构地区：[1]华中科技大学同济医学院附属协和医院感染科,武汉430022 [2]华中科技大学同济医学院附属协和医院传染病实验室,武汉430022 [3]华中科技大学同济医学院附属协和医院中心实验室,武汉430022

出　　处：《中国免疫学杂志》2010年第2期174-177,共4页Chinese Journal of Immunology

摘　　要：目的:探索核苷类似物早期病毒学应答慢性乙型肝炎患者(CHB)血清sTRAIL水平变化及意义。方法:60例CHB均接受核苷类似物抗病毒药物治疗(拉米夫定或替比夫定),根据治疗24周末HBVDNA水平将患者分为完全病毒学应答组、部分病毒学应答组、无病毒学应答组,设正常对照组。采集治疗前、治疗4、12、24周末患者的血清,检测血清sTRAIL水平,同时检测IFN-γ、ALT水平。结果:患者治疗前sTRAIL、IFN-γ及ALT水平均较正常对照组升高(P<0.05或P<0.01)。sTRAIL水平在完全应答组治疗4周末、部分应答组治疗12周末下降。与治疗前比,差异均有统计学意义(P<0.05),在治疗4周末完全应答组sTRAIL水平低于同期部分应答组(P<0.05)。IFN-γ水平在完全应答组治疗4周末、部分应答组治疗12周末升高,与治疗前比差异均有统计学意义(P<0.05),但完全应答组IFN-γ水平在治疗4周末与同期部分应答组差异无统计学意义。ALT水平在三组的治疗过程中均逐步下降,各时间点间差异均有统计学意义(p<0.05)。完全应答组治疗前sTRAIL水平与IFN-γ水平、ALT水平呈正相关(P<0.01),治疗后sTRAIL水平与IFN-γ水平呈负相关(P<0.05)。结论:CHB血清sTRAIL水平升高;核苷类似物抗病毒治疗早期病毒学应答者血清sTRAIL水平下降,尤其是完全应答者在疗程的第4周就有明显的变化。sTRAIL在CHB免疫损伤中起重要作用,在其核苷类似物抗病毒治疗免疫恢复中也起重要作用,可作为核苷类似物治疗CHB早期应答指标预测远期疗效。Objective：To study the sTRAIL levels in chronic hepatitis B（CHB） patients upon uncleoside analogues therapy.Methods： Serial sera of 60 CHB patients before and after nucleoside analogues therapy were collected, among which there were 20 complete responding eases,20 partial responding cases,20 non-responding cases, and 10 healthy poople. The level of sTRAIL, IFN-γ and ALT were detected. Resuits： The level of sTRAIL, IFN-γ and ALT of CHB patients were higher than that of normal group. The sTRAIL level of complete responding group at 4 weeks and partial responding group at 12 weeks were lower than those before therapy, while serum TRAIL of complete responding group were lower than those of partial responding group at 4 weeks.The IFN-γ level of complete responding group at 4 weeks and partial responding group at 12 weeks were higher than those before therapy. ALT levels of all groups in the course of therapy declined gradually and significant difference was observed at different time point. Conclusion： Serum TRAIL level can be used as an early marker for efficacy of nucleoside analogues therapy efficacy in CHB patients, sTRAIL may play a role in restoring immune injury of early anti-viral response in patients with hepatitis B.

关 键 词：TRAIL 慢性乙型肝炎 核苷类似物 早期应答 

分 类 号：R512.62[医药卫生—内科学]