HBeAg阴性慢性乙型肝炎获得HBsAg清除与血清白细胞介素17水平的关系  

Association between serum level of interleukin-17 and HBsAg clearance in patients with HBsAg-negative chronic hepatitis B

作　　者：曹振环[1] 柳雅立[1] 马丽娜[1] 鲁俊锋[1] 金怡[1] 何智敏[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肝病综合科,北京100069

出　　处：《临床肝胆病杂志》2016年第7期1292-1295,共4页Journal of Clinical Hepatology

基　　金：国家"十二五"科技重大专项(013ZX1000 2002-006);首都临床特色应用研究(Z151100004015181.Z161100000516018);首都卫生发展科研专项项目(首发2011-2018-08;首发2016-1-2183);北京佑安医院肝病艾滋病基金中青年孵育项目(YNKT20160021)

摘　　要：目的探讨聚乙二醇干扰素（PEG-IFN）治疗HBeAg阴性慢性乙型肝炎（CHB）发生HBsAg清除与血清白细胞介素（IL）17水平的关系。方法选择2012年1月-2015年1月于北京佑安医院就诊的HBeAg阴性CHB患者13例,经PEG-IFN治疗24周,其中6例获得HBsAg清除（R组）,7例未获得HBsAg清除（NR组）。用Luminex技术检测患者基线、治疗12周和24周血清IL-17水平。同时检测10例健康人和6例急性乙型肝炎（AHB）患者发病时的血清IL-17水平。计量资料两组间比较采用t检验,多组间比较采用方差分析,进一步两两比较采用SNK-q检验;计数资料组间比较采用χ^2检验。结果 AHB组基线血清IL-17水平最高,其次是CHB组,健康对照组最低,3组间比较差异有统计学意义（P〈0.05）。CHB患者经PEG-IFN治疗24周后,IL-17水平较基线明显下降（P=0.044）。R组基线血清IL-17水平高于NR组,而且在PEG-IFN治疗后明显下降;而NR组IL-17升高或降低不明显。结论 PEG-IFN治疗HBeAg阴性CHB患者,IL-17基线高水平和治疗过程中明显降低可能有利于HBsAg清除。Objective To investigate the association between HBsAg clearance and serum level of interleukin- 17（ IL- 17） in HBeAg-negative chronic hepatitis B（ CHB） patients treated by pegylated interferon（ PEG- IFN）. Methods A total of 13 HBeAg- negative CHB patients who visited Beijing You An Hospital from January 2012 to January 2015 were enrolled. After the 24- week treatment with PEG-IFN,6 achieved HBsAg clearance（ R group） and 7 did not achieve HBsAg clearance（ NR group）. The Luminex technology was used to measure the serum level of IL- 17 at baseline and weeks 12 and 24 of treatment. Ten healthy controls and 6 patients with acute hepatitis B（ AHB） were enrolled and serum level of IL- 17 was measured. An analysis of variance was used for comparison of continuous data between multiple groups,and the SNK- qtest was used for further pairwise comparison; the t- test was used for comparison of continuous data between any two groups; the chi- square test was used for comparison of categorical data between groups. Results The AHB group had the highest serum level of IL- 17 at baseline,followed by the CHB group and healthy control group,and the serum level of IL- 17 at baseline showed significant differences between the three groups（ P〈0. 05）. After the PEG- IFN treatment for 24 weeks,HBeAg- negative CHB patients showed a significant reduction in serum level of IL- 17（ P = 0. 044）. R group had a significantly higher serum level of IL- 17 than NR group and showed a significant reduction in the serum level of IL- 17 after PEG- IFN treatment,while NR group showed no significant increase or reduction in the serum level of IL- 17. Conclusion In the PEG- IFN treatment for HBeAg- negative CHB patients,a high serum level of IL- 17 at baseline and a significant reduction in serum level of IL- 17 helps with HBsAg clearance.

关 键 词：肝炎 乙型 慢性 肝炎e抗原 乙型 肝炎表面抗原 乙型 白细胞介素17 

分 类 号：R512.62[医药卫生—内科学]