可溶性人类白细胞抗原G对丙型肝炎初治患者标准化治疗疗效的影响  

Effects of soluble human leukocyte antigen G on the standardized treatment of hepatitis C patients

作　　者：周勇 应莉 徐佳佳 丁世雄[2] 胡爱荣[3] 高国生[2] ZHOU Yong;YING Li;XU Jiajia;DING Shixiong;HU Airong;GAO Guosheng(Taizhou Central Hospital（Affiliated Hospital of Taizhou College）Laboratory Center,Taizhou 318000,Zhejiang,China;Department of Clinical Laboratory,Second Hospital of Ningbo,Ningbo 315010,Zhejiang,China;Department of Liver Diseases,Second Hospital of Ningbo,Ningbo 315010,Zhefiang,China)

机构地区：[1]台州市中心医院(台州学院附属医院)检验中心 [2]宁波市第二医院检验科 [3]宁波市第二医院肝病科

出　　处：《中国临床药理学与治疗学》2018年第7期809-813,共5页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：宁波市自然科学基金(2013A610239);浙江省医药卫生省部培育计划基金资助项目(2014PYA018)

摘　　要：目的:探讨可溶性人类白细胞抗原G(s HLA-G)对慢性丙型肝炎(CHC)患者聚乙二醇干扰素联合利巴韦林抗病毒治疗疗效的影响。方法:选择2013年10月至2015年10月就诊的63例CHC患者,分别采用基因芯片法、RT-PCR法和ELISA方法检测丙型肝炎病毒(HCV)基因型、HCV RNA和s HLA-G。所有患者接受聚乙二醇干扰素皮下注射,联合口服利巴韦林抗病毒治疗。分析获得持续病毒学应答(SVR)的影响因素。结果:SVR组女性和非基因1型比例均显著高于非持续病毒学应答(NSVR)组(女性:70.59%vs.44.83%,χ2=4.285;非基因1型:82.76%vs.55.88%,χ2=5.217,P均<0.05),其余基线指标均无统计学差异(P均>0.05)。NSVR组患者治疗前血浆s HLA-G水平显著高于SVR组[1.85(1.49-16.00)ng/L vs.1.53(1.36-2.80)ng/L;U=329.00,P<0.05]。经过多变量logistic回归分析,发现s HLA-G和HCV基因型是与治疗结局相关的独立影响因子,Exp(B)(95%CI)分别为0.922(0.868-0.978)、14.204(1.898-106.289)。结论:s HLA-G对丙型肝炎初治患者标准化治疗疗效有重要影响,特别是低水平者更容易获得持续病毒学应答。AIM：To investigate the effect of soluble human leukocyte antigen G（s HLA-G） on the efficacy of pegylated interferon combined with ribavirin in the treatment of chronic hepatitis C（CHC）.METHODS：A total of 63 CHC patients from October 2013 to October 2015 were enrolled.The genotype of hepatitis C virus（HCV）,HCV RNA and s HLA-G were detected by gene chip,RTPCR and ELISA method accordingly.All patients received a subcutaneous injection of pegylated interferon combined with oral ribavirin.The factors affecting the sustained virological response（SVR）were observed and analyzed.RESULTS：The proportion of female and non-genotype 1 in SVR group was significantly higher than that in non-sustained virological response（NSVR） group（female：70.59% vs.44.83%,χ2= 4.285;non-genotype 1：82.76% vs.55.88%,χ2= 5.217,P〈0.05）;other baseline indexes presented no significant difference（P〈0.05）.The level of plasma s HLA-G before treatment in NSVR group was significantly higher than that in SVR group[1.85（1.49-16.00） ng/L vs.1.53（1.36-2.80） ng/L;U = 329.00,P〈0.05].After multivariable logistic regression analysis,s HLA-G and HCV genotypes were the independent influencing factors associated with the outcome of treatment with Exp（B）（95% CI） were0.922（0.868-0.978） and 14.204（1.898-106.289）,respectively.CONCLUSION：s HLA-G exhibits an important effect on the standardized treatment of hepatitis C patients,and patients with low s HLA-G level are more likely to achieve a sustained virological response.

关 键 词：慢性丙型肝炎 利巴韦林 治疗 聚乙二醇干扰素 可溶性人类白细胞抗原G 

分 类 号：R749[医药卫生—神经病学与精神病学]