血清趋化因子对HBeAg阳性慢性乙型肝炎患者经聚乙二醇干扰素α治疗后持续病毒学应答的影响  

Effects of serum levels of chemokines on sustained virological response in patients with HBeAg-positive chronic hep-atitis B after treatment with pegylated interferon α-2b

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

机构地区：[1]徐州医学院附属医院感染病科,江苏徐州221002

出　　处：《临床肝胆病杂志》2016年第3期467-471,共5页Journal of Clinical Hepatology

基　　金：江苏省临床科技专项(BL2012043)

摘　　要：目的研究HBe Ag阳性慢性乙型肝炎患者聚乙二醇干扰素(PEG-IFN)治疗过程中血清γ-干扰素诱导蛋白-10(IP-10)、γ-干扰素诱导单核因子(Mig)及调节激活正常T淋巴细胞表达和分泌因子(RANTES)水平变化特点及其对PEG-IFN疗效的预测价值。方法收集2012年2月-2013年12月于徐州医学院附属医院接受PEG-IFNα-2b治疗的HBe Ag阳性CHB患者53例,其中46例完成48周治疗后继续随访24周,根据有无出现持续病毒学应答(SVR)分为A组(出现SVR,n=17)和B组(未出现SVR,n=29)。测定患者基线,治疗12、24、48周及治疗后24周外周静脉血清IP-10、Mig、RANTES、HBV DNA、HBs Ag及ALT水平。计量资料两组间比较采用t检验,组内两两比较采用配对t检验,相关性采用Pearson相关系数分析。计数资料组间比较采用χ2检验。结果患者基线血清IP-10、Mig水平A组显著高于B组,HBs Ag水平A组则低于B组,差异均有统计学意义(t值分别为2.696、2.963、2.401,P值均<0.05)。患者基线IP-10、Mig与ALT水平呈正相关,差异均有统计学意义(r值分别为0.570、0.317,P值均<0.05)。与基线比较,治疗12、24周时的血清HBV DNA、HBs Ag、ALT和Mig水平均显著降低,差异均有统计学意义(12周时t值分别为2.126、2.217、2.376、2.776,24周时t值分别为2.635、2.453、2.627、2.803,P值均<0.05)。46例患者治疗前、治疗12及24周时2组患者的IP-10、Mig水平比较差异均有统计学意义(P值均<0.05);A组内,与基线比较,12、24周时的Mig水平显著降低,差异有统计学意义(t值分别为3.061、3.105,P值均<0.01);B组内,与基线相比,24周时血清Mig水平显著降低(t=2.632,P<0.01)。基线血清IP-10、Mig和HBs Ag水平对SVR均有预测价值(P值均<0.05)。46例患者中基线Mig>80 pg/ml的20例患者中获得SVR 12例(60.0%),基线Mig<80 pg/ml的26例患者中仅有5例(19.2%)实现SVR,两者相比差异有统计学意义(χ2=8.06,P<0.01);46例患者中基线IP-10>120 pg/ml的25例患者中获得SVR有12例(48Objective To investigate the changes in serum levels of interferon（ IFN）- γ- inducible protein 10（ IP- 10）,monokine induced by IFN- γ（ Mig）,and chemokine regulated upon activation,normal T cell expressed and secreted（ RANTES） in patients with HBe Ag- positive chronic hepatitis B（ CHB） undergoing pegylated interferon（ PEG- IFN） therapy,and to explore their predictive values for the efficacy of PEG- IFN therapy. Methods Fifty- three patients with HBe Ag- positive CHB who received PEG- IFN α- 2b therapy in our hospital from February 2012 to December 2013 were enrolled as subjects. Forty- six out of the fifty- three patients were followed up for 24 weeks after 48 weeks of treatment. According to the incidence of sustained virological response（ SVR）,these patients were divided into A group（ SVR,n = 17） and B group（ NO SVR,n = 29）. Serum levels of IP- 10,Mig,RANTES,hepatitis B virus（ HBV） DNA,HBs Ag,and alanine aminotransferase（ ALT） in peripheral venous blood were measured at baseline,after 12,24,and 48 weeks of treatment,and at 24 weeks after treatment. Comparison of continuous data between two groups and within the groups was made by t test and paired t test,respectively. Correlation was analyzed using the Pearson correlation coefficient. Between- group comparison of categorical data was made by χ2test. Results Compared with the B group,the A group had significantly higher baseline serum levels of IP- 10 and Mig and a significantly lower level of HBs Ag（ t = 2. 696,P 〈 0. 05; t = 2. 963,P 〈 0. 05; t = 2. 401,P 〈 0. 05）. The baseline levels of IP- 10 and Mig were positively correlated with the baseline level of ALT（ r = 0. 570,P 〈 0. 05; r = 0. 317,P 〈 0. 05）. Compared with the baseline levels,patients had significantly reduced serum levels of HBV DNA,HBs Ag,ALT,and Mig after 12 weeks of treatment（ t = 2. 126,P 〈0. 05; t = 2. 217,P 〈 0. 05; t = 2. 376,P 〈 0. 05; t = 2. 776,P 〈 0. 05） and 24 weeks of treatment（ t = 2. 635,P 〈 0. 05; t =

关 键 词：肝炎 乙型 慢性 炎症趋化因子类 干扰素Α 

分 类 号：R512.62[医药卫生—内科学]