慢性丙型肝炎初治和复治患者的细胞因子特征与病毒学应答  

Cytokine profiles and virological response in treatment-na?ve and-experienced patients with chronic HCV infection

作　　者：柳雅立[1] 张永宏[1] 郭丹丹[1] 鲁俊锋[1] 于海滨[1] 画伟[1] 陈新月[1] 

机构地区：[1]首都医科大学附属北京佑安医院国际医疗部,100069

出　　处：《传染病信息》2012年第2期96-99,共4页Infectious Disease Information

基　　金：国家"十一五"科技重大专项(2008ZX10002-013;2008-ZX10002-004)

摘　　要：目的分析比较慢性丙型肝炎初治和复治患者细胞因子水平,并探讨其与疗效间的关系。方法选取慢性丙型肝炎初治患者37例和复治患者24例,均接受聚乙二醇干扰素α-2a联合利巴韦林治疗,动态留取标本并检测细胞因子变化,分析其与疗效的关系。11例健康者作为对照组。结果与初治患者能获得较早的病毒学应答相比,复治组12例(50%)在治疗48周时才获得病毒学应答。初治组白细胞介素-4、干扰素(interferon,IFN)γ、CCL-3(MIP-1a)显著高于复治组(P=0.005);初治组粒细胞集落刺激因子水平则低于复治组(P<0.05)。在基线和治疗4周时,初治组较高的IFNγ水平与HCV清除率相关。结论复治患者能否获得治疗成功与宿主免疫应答相关,IFNγ可能是病毒学应答的重要预测因子。Objective To analyze and compare cytokine levels in treatment-na＇a＇ve and -experienced patients with chronic HCV infection, and to investigate correlation between those immunological factors and antiviral therapy efficacy. Methods Thirty-seven treatment-naYve and 24 treatment-experienced patients with chronic HCV infection received combination therapy with pegylated in- terferon alfa-2a and ribavirin. Samples was collected dynamically to detect the changes of eytokine levels and the correlation be- tween cytokine levels and therapeutic efficacy was analyzed. Eleven healthy donors were recruited as the controls. Results Twelve （50%） treatment-experienced patients with chronic HCV infection achieved a delayed and slow virological response after 48 weeks of combination therapy compared with treatment-na＇fve patients, who had an early and fast virological response. The levels of interleu- kin-4, interferon （IFN）y and CCL-3 （MIP-la） were significantly higher in treatment-na＇fve patients than those in treatment- experienced patients （P=0.005）, while the level of granuloeyte colony-stimulating factor in treatment-na＇tve patients was lower than that in treatment-experienced patients （P〈0.05）. Higher IFN y levels at baseline and week 4 were associated with HCV clearance in treatment-na＇fve patients. Conclusions A successful retreatment in treatment-experienced patients appeares to be correlated with the host immune response. IFN y may be a potential predictor for virological response.

关 键 词：丙型肝炎病毒 白细胞介素 免疫疗法 主动 对照组 

分 类 号：R373.21[医药卫生—病原生物学]