慢性丙型肝炎患者白介素-28B 基因多态性与中医证候演化及肝纤维化的相关性研究  

Study on the relationship between IL-28B gene polymorphism and traditional Chinese medicine syndrome type and liver fibrosis in patients with chronic hepatitis C

作　　者：刘粤[1] 朱质斌[1] 黄亮[1] 王敏[1] 张国良[1] 吴其恺[1] 王松[1] 戴炜[1] 周伯平[1] 

机构地区：[1]广东医学院附属深圳市第三人民医院,广东深圳518112

出　　处：《中西医结合肝病杂志》2015年第6期331-333,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：深圳市科技创新项目(No.JCYJ20130401164750000)

摘　　要：目的：本项目采用焦磷酸测序法对慢性丙型肝炎（CHC）患者的IL-28B基因SNP进行分型,明确CHC患者中IL-28B等位基因频率与其中医证候、肝纤维化的分布特征,借以比较肝纤维化在不同IL-28B等位基因及中医证候患者中的发生率,并指导今后针对CHC患者尤其是可能进展为肝硬化的高危患者的治疗。方法：采用焦磷酸测序法对在我院门诊及住院的105例CHC初治患者的IL-28B基因rs12979860 SNP位点的基因型进行检测,完善其血生化、病理学等检查,再对其进行中医辨证分型,比较不同等位基因中的中医证候的分布及不同证候中肝纤维化患者所占的比例。结果：采用焦磷酸测序法测得我院CHC患者的IL-28B基因分型为CC型（90例）及CT型（15例）。在等位基因为CC型的CHC患者中,中医证候为肝肾阴虚的患者比例最多[41.3%（37/90）],而CC型患者中肝纤维化的比例为53.3%（48/90）,CT型为20%（3/15）,差异有显著性意义（P〈0.05）,其中CC型患者中医证候为肝肾阴虚的发生肝纤维化的相对危险度RR值为4.1,95%CI为1.6-10.2。结论：IL-28B等位基因为CC型的CHC患者主要中医证候为肝肾阴虚,CC型比CT型更容易发生肝纤维化,CC型中肝肾阴虚患者发生肝纤维化的概率最高,我们应加强对IL-28B等位基因为CC型患者的治疗与监测。Objective：To type the IL-28 B SNP of chronic hepatitis C and to find the relationship between the distribution of IL-28 B allele frequencies in patients with chronic hepatitis C and their traditional Chinese medicine（TCM）syndrome as well as liver fibrosis. So as to compare the occur rate of fibrosis in different IL-28 B allele and TCM syndrome patients,to guide the future treatment for chronic hepatitis C patients, especially for the high-risk patients who may progress to cirrhosis. Methods： The pyrosequencing method was used to test rs12979860 of IL-28 B gene SNP genotypes in 105 cases of outpatients and in patients with chronic hepatitis C of our hospital, and blood biochemistry and pathological examination was also performed. And patients were differentiated TCM syndrome types in the order to compare the distribution of TCM syndrome types in different IL-28 B alleles and the proportion fibrosis in different TCM syndrome type. Results：The IL-28 B genotyping of chronic hepatitis C in our hospital was divided into CC（90 cases）and CT（15 cases）. TCM syndrome type of deficiency of liver-yin and kidney-yin was largest percentage of chronic hepatitis C patients with CC alleles（37 cases,accounted for 41.3%）,and the proportion of liver fibrosis in patients with CC genotype was 53.3%,with CT type was 20%.The difference was statistically significant（ P〈0.05）,the relative risk（RR）of the deficiency of liver-yin and kidney-yin compare to other TCM syndrome types in CC genotype was 4.1（95% CI 1.6-10.2）.Conclusion：Deficiency of liver-yin and kidney-yin was the major TCM syndrome type in the chronic hepatitis C patients with IL-28 B genotype CC allele,fibrosis was more likely occur in patients with CC allele than CT allele,and deficiency of liver-yin and kidney-yin in patients with CC allele had highest probability to occur fibrosis than other TCM syndrome types,we should strengthen the treatment and monitoring of patients with IL-28 B genotype CC allele.

关 键 词：白细胞介素-28B 丙型肝炎病毒 肝纤维化 中医证候 

分 类 号：R512.63[医药卫生—内科学]