慢性丙型肝炎患者抗病毒疗效与血清Th1/Th2类细胞因子水平的相关分析  

Correlation between antiviral efficacy and serum levels of Th1/Th2 cytokines in patients with chronic hepatitis C

作　　者：郭丹丹[1] 张永宏[1] 马丽娜[1] 柳雅立[1] 鲁俊锋[1] 金怡[1] 何智敏[1] 画伟[1] 郑燕红[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》2013年第2期103-107,共5页Infectious Disease Information

基　　金：国家"十一五"科技重大专项(2008ZX10002-013);国家"十二五"科技重大专项(2012ZX10002003);首都市民健康项目培育(Z111107067311049)

摘　　要：目的探讨慢性丙型肝炎(chronic hepatitis C,CHC)患者抗病毒疗效与血清辅助性T细胞(helper T,Th)1/Th2类细胞因子水平的关系。方法对2010年7月-2011年5月于我院就诊的75例接受聚乙二醇干扰素(pegylated interferon,Peg-IFN)α-2a联合利巴韦林(ribavirin,RBV)治疗的CHC患者(CHC组)的抗病毒疗效进行评估。用Luminex技术检测基线、治疗4周和治疗12周血清Th1类细胞因子[白细胞介素(interleukin,IL)-2、IL-12、IFNγ和肿瘤坏死因子(tumor necrosis fac-tor,TNF)-α]水平及Th2类细胞因子(IL-4、IL-5、IL-6、IL-10和IL-13)水平,并与11例健康志愿者(正常对照组)进行比较。结果 CHC组绝大多数Th1/Th2类细胞因子水平高于正常对照组,仅TNF-α水平低于正常对照组(P<0.05);获得治疗结束时病毒学应答(end of treatment virological response,ETVR)患者(ETVR组)的Th1类细胞因子IFNγ水平在基线、治疗4周和治疗12周均高于未获得ETVR的患者(nETVR组)(P<0.05),TNF-α水平在基线和治疗4周均高于nETVR组(P<0.05);ETVR组Th2类细胞因子IL-4水平在基线、治疗4周和治疗12周均低于nETVR组(P<0.05)。结论 Peg-IFNα-2a联合RBV治疗过程中Th1类细胞因子优势反应有利于获得病毒学应答。Objective To investigate the correlation between antiviral efficacy and serum levels of helper T （Th）l/Th2 cy tokines in patients with chronic hepatitis C （CHC）. Methods Totally 75 CHC patients who received combination therapy of pegy lated interferon （Peg-IFN） a-2a plus ribavirin （RBV） in our hospital from Jul. 2010 to May 2011 were enrolled in the study. The an- tiviral efficacy was evaluated. The serum levels of Thl cytokines [interleukin （IL）-2, IL-12, IFN ＂y and tumor necrosis factor （TNF）- c and Th2 cytokines （IL-4, IL-5, IL-6, IL-10 and IL-13） were detected at baseline, week 4 of treatment and week 12 of treatment by Luminex technology and compared with those of 11 healthy controls （the control group）. Results The levels of most Thl/Th2 cytokines of CHC group were higher than those of the control group, only TNF-a level lower than that of the control group （P〈0.05）. IFN levels of patients obtaining end of treatment virological response （ETVR） （ETVR group） were higher than those of patients without obtaining ETVR （nETVR group） at baseline, week 4 of treatment and week 12 of treatment （P〈0.05）, and TNF-ot levels of ETVR group were higher than those of nETVR group at baseline and week 4 of treatment （P〈0.05）. IL-4 levels of ETVR group were lower than those of nETVR group at baseline, week 4 of treatment and week 12 of treatment （P〈0.05）. Conclusion During the combination therapy of Peg-IFN a-2a plus RBV, the dominance of Thl cytokines can provide benefits for obtaining virological response.

关 键 词：丙型肝炎 慢性 白细胞介素类 免疫疗法 主动 

分 类 号：R512.63[医药卫生—内科学]