ELISPOT、ELISA指导拉米夫定治疗HBV感染  

HBV infection treatment on using Lamivadine instructed by the method of ELISPOT, ELISA

作　　者：施理[1] 林锋[1] 许小珍[1] 贾杰[1] 陈所贤[1] 周炎腾[1] 沈伟[1] 

机构地区：[1]海南省人民医院传染科,海南海口570311

出　　处：《现代预防医学》2013年第14期2745-2748,共4页Modern Preventive Medicine

基　　金：海南省自然基金(200831);海南省卫生厅项目(200816)

摘　　要：目的酶联免疫斑点(enzyme link immunal spot,ELISPOT)、酶联免疫吸附试验(Enzyme-Linked Immunosorb-nent Assay,ELISA)鉴别HBV感染免疫状态,指导拉米夫定治疗。方法用ELISPOT及ELISA方法鉴别免疫耐受期、免疫清除期患者,研究2组对拉米夫定治疗效果。结果用ELISA方法,2组患者PBMCs受HBcAg刺激分泌IFNr,分别为(578.37±7.73)ng/L、(655.25±3.80)ng/L,阳性率分别为12.50%和68.81%,差异有统计学意义(P﹤0.001);2组患者ELISPOT阳性率分别为0、87.50%,二者差异有统计学意义(P=4.23×10-8)。2组患者HBV载量差异有统计学意义(χ20.01(2)=15.13,P﹤0.01),对拉米夫定治疗反应差异有统计学意义(χ20.01(2)=11.73,P﹤0.01);拉米夫定不同治疗效果的患者,HBV载量差异有统计学意义(χ20.05(4)=9.93,P﹤0.05)。结论免疫清除期、免疫耐受期HBV感染者,PBMCs对HBcAg刺激的免疫反应不同,鉴别二者,ELISPOT优于ELISA。拉米夫定治疗效果与患者机体HBV载量、免疫状态有关。OBJECTIVE The immune response of the patients with HBV was compared by the method of Enzyme Link Immune Spot （ ELISPOT） and Enzyme-Linked Immunosorbnent Assay （ ELISA） , which direct the usage of Lamivudine. METHODS Patients chronically infected with HBV were divided into patients in clerance period and patients in tolerance period by the method of ELISA and ELISPOT. The effect of Lamivudine in both groups were also studied. RESULTS For the patients in tolerance period and clerance period, the production of interferon-r （IFNr） from Peripheral blood mononuclear cells （PBMCs） by the stimulation of HBcAg were （578.37ng / L ± 7.73ng / L） and （655.25 ng / L ± 3.80ng / L） respectively, and 12.50% patients in tolerance period and 68.81% patients in clerance period were positive by the method of ELISA. By the method of ELISPOT, 0% and 87.50% of patients in tolerance period and clerance period were positive respectively , and there was a statistical difference （P = 4.23×10 -8 ）. There were statistical differences of HBV level （χ 2 0.01 （2） =15.13, P﹤0.01）, and reponses to Lamivudine （χ 2 0.01（2） = 11.73, P﹤0.01） between the patients in clerance period and in tolerance period. There was a statistical difference of HBV level in the patients with various responses to Lamivudine （ χ 2 0.05 （4） = 9.93, P ﹤ 0.05）. CONCLUSION The response of the production of IFNr stimulated with HBcAg for the patients in clerance period is evidently different from those in tolerance period, and ELISPOT is better than ELISA. The effect of Lamivudine is related to the HBV level and immune response to HBV.

关 键 词：HBV感染者 INFr ELISA ELISPOT 拉米夫定 

分 类 号：R512.62[医药卫生—内科学]