抗病毒治疗过程中慢性乙型肝炎患者外周血辅助性T细胞因子的变化  

Changes of the peripheral T helper cell cytokines of patients with chronic hepatitis B during antiviral treatment

作　　者：赵学辉[1] 杨介钻[1] 胡云良[2] 鲁海峰[1] 魏丽[1] 王保红[1] 李兰娟[1] 

机构地区：[1]浙江大学医学院附属第一医院传染科传染病诊治国家重点实验室,杭州310003 [2]温州医学院附属第二医院检验科

出　　处：《中华传染病杂志》2011年第11期664-668,共5页Chinese Journal of Infectious Diseases

基　　金：国家重点基础研究发展973计划项目（2007CB513003、2009CB522406）;浙江省重点科技创新团队资助项目（2009R50041）

摘　　要：目的观察慢性乙型肝炎（CHB）患者外周血辅助性T细胞因子水平在抗病毒治疗过程中的变化，进一步探讨其与CHB发病的关系。方法在33例CHB患者采用恩替卡韦抗病毒治疗过程的不同时期，采用ELISA法检测其外周血IL-2、IL-6、IL-10、IFNγ和TNF-α水平，并同时检测患者肝功能。治疗前后细胞因子水平比较采用单因素方差分析，细胞因子水平变化与ALT、HBVDNA水平间行相关性分析。结果IFNγ水平在治疗前及治疗12、24、48周分别为（5．98±2．77）、（5．95±3．37）、（2．93±2．15）、（9．29±4．65）pg／mL（F=3．845，P〈0．05），与ALT呈正相关（r=0．396，P〈0．05）；TNF—α及IL-10治疗前后呈逐渐下降趋势，各时期间差异有统计学意义（F=20．156，16．695；均P〈0．05），与ALT均呈正相关（r=0．354，0．316；均P〈0．05），与HBV DNA也均呈正相关（r=0．382，0．386；均P〈0．05）；IL2、IL-6治疗前后各时期间差异无统计学意义（F=0．010，0．932；均P〉0．05）。治疗前及治疗后各时期ALT、HBV DNA水平间差异有统计学意义（F=17．69，198．98；均P％0．05），均随抗病毒治疗时间的延长逐渐降低，且两者间呈正相关（r=0．581，P〈0．05）。结论IL-10、IFNγ、TNF-α等细胞因子可能参与CHB病理过程，并与肝炎的病情变化密切相关，抗病毒过程中检测其血浆浓度有助于了解机体免疫情况，评价抗病毒药物疗效。Objective To determine the changes of peripheral levels of T helper cell cytokines of patients with chronic hepatitis B （CHB） during antiviral treatment,and to further explore its clinical significance. Methods The plasma levels of interleukin （IL）-2, IL-6, IL- 10, interferon （IFN）-γ and tumor necrosis factor（TNF）-α of thirty-three CHB patients during antiviral treatment （enteeavir） were measured using enzyme linked immunosorbont assay （ELISA）. And their biochemical indicators of liver function were determined. The differences of cytokines levels before and after antiviral treatment were compared using ANOVA. The correlations between the changes of cytokines and alanine transaminase （ALT）, hepatitis B virus （HBV） DNA levels were analyzed. Results Levels of IFN7 before and 12, 24, 48 weeks after treatment were （5.98±2.77）, （5.95±3.37）, （2.93±2.15） and （9.29 ±4.65 ） pg/mL, respectively （ F = 3. 845, P 〈 0.05 ）, which were positively correlated with ALT levels （r = 0. 396, P〈0.05）. Both TNF-α and IL-10 levels declined after antiviral treatment,which were significantly different at different time points （F=20. 156 and 16. 695, respectively; both P〈0.05）, and both levels of TNF-α and IL-10 were positively correlated with ALT levels （r=0. 354 and 0. 316, respectively; both P〈0.05） and positively correlated with HBV DNA levels （r=0. 382 and 0. 386, respectively; both P〈0. 05）. While both IL-2 and IL-6 levels were not significantly different between before and after antiviral treatment （F= 0. 010 and 0. 932, respectively; both P〉 0.05）. The serum levels of ALT and HBV DNA before and after antiviral treatment were all significantly different （F= 17.69 and 198.98, respectively; both P〈0.05）, which declined gradually during treatment and were positively correlated （r = 0. 581, P〈0.05）. Conclusions IL-10, IFNγ and TNF-α may be involved in the pathologic process of CHB, and closely related to the deterioration of the dise

关 键 词：肝炎 乙型 慢性 白细胞介素-10 干扰素Ⅱ型 肿瘤坏死因子-Α 抗病毒药 

分 类 号：R51[医药卫生—内科学]