IL-21预测HBeAg阳性慢性乙型肝炎患者干扰素治疗应答的价值  

Role of serum IL-21 level in predicting outcomes of interferon therapy in patients with HBeAg positive chronic hepatitis B

作　　者：王霞[1] 李彦[1] 刘瑞霞[1] 傅涓涓[1] 成立伟 李丽[1] 潘修成[1] 

机构地区：[1]徐州医学院附属医院感染病科,江苏省221002

出　　处：《江苏医药》2016年第5期539-542,共4页Jiangsu Medical Journal

基　　金：江苏省临床医学科技专项(BL2012043)

摘　　要：目的探讨IL-21水平在预测干扰素(IFN)治疗慢性乙型肝炎(CHB)疗效中的价值。方法 69例HBeAg阳性CHB患者接受IFN治疗48周。ELISA法检测治疗前和治疗12、24、36、48周外周血清IL-21水平,化学发光微粒子免疫检测法定量检测血清HBVM,荧光定量PCR检测血清HBV DNA水平。结果治疗48周时,22例(31.9%)为完全应答(CR)状态,出现HBeAg血清学转换,且HBV DNA<500IU/ml;其余47例(68.1%)为非完全应答(NCR)状态。CR组基线血清IL-21水平高于NCR组(P<0.05)。基线IL-21≥110pg/ml对CR的预测价值达到66.7%;其中,IL-21≥110pg/ml,且HBsAg定量≤3.84log_(10)IU/ml的CHB患者中80.0%能够实现CR。结论治疗前血清IL-21高表达的HBeAg阳性CHB患者预示IFN治疗效果较好。Objective To explore the role of serum IL-21 levels in predicting the outcomes of interferon（IFN）therapy in the patients with HBeAg positive chronic hepatitis B（CHB）.Methods Sixty-nine CHB patients with HBeAg positive were treated with IFN for 48 weeks.Serum levels of IL-21 were detected by ELISA before and in the 12^（th）,24^（th）,36 ^（th）,and 48 ^（th） week of IFN treatment.Serum level of HBV-M was detected by chemiluminescent micropartical immunoassay and that of HBV DNA was detected by fluorescence quantitative PCR.Results Of 69 patients,22 cases（31.9%）had complete response（group CR）to IFN therapy with HBeAg disapprearance,HBeAb apprearance and HBV DNA500IU/ml.Another 47cases（68.1%）had no complete response（group NCR）.Serum level of IL-21 before treatment was significantly higher in group CR than that in group NCR（P〈0.05）.Before treatment,66.7% of CR patients had serum IL-21levels≥110pg/ml and 80.0%of them had serum IL-21levels≥110pg/ml as well as HBsAg levels≤3.84log_（10） IU/ml.Conclusion High expression of serum IL-21 predicts a better efficacy of IFN therapy in CHB patients with HBeAg positive.

关 键 词：白细胞介素21 乙型肝炎E抗原 干扰素 慢性乙型肝炎 

分 类 号：R512[医药卫生—内科学]