聚乙二醇干扰素α-2b治疗慢性乙型肝炎患者外周血T淋巴细胞亚群和血清细胞因子水平变化  

Effect of pegylated interferon α-2b on peripheral blood T lym phocyte subsets and serum cytokine levels in patients with chronic hepatitis B

作　　者：罗丹 陈勇[1] 陈清[1] 万十千[2] Luo Dan;Chen Yong;Chen Qing(Second Department of Infectious Diseases,Jinyintan Hospital,Wuhan 430000,Hubei Province,China)

机构地区：[1]武汉市金银潭医院(原武汉市医疗救治中心)感染性疾病二科,430000 [2]武汉市金银潭医院(原武汉市医疗救治中心)中西医结合肝病科

出　　处：《实用肝脏病杂志》2018年第2期200-203,共4页Journal of Practical Hepatology

摘　　要：目的研究聚乙二醇干扰素α-2b治疗慢性乙型肝炎患者外周血T淋巴细胞亚群和血清细胞因子水平的变化。方法 2014年1月~2016年1月我院收治的184例慢性乙型肝炎患者,92例接受聚乙二醇干扰素α-2b联合恩替卡韦治疗48 w,另92例只接受恩替卡韦治疗。使用流式细胞仪检测外周血T淋巴细胞亚群,采用放射免疫法检测血清IL-6、INF-ɑ、IL-4,采用酶联免疫吸附法检测血清IL-17、TGF-β1和HBV标记物,采用荧光定量PCR法检测血清HBV DNA、核转录因子RORγt、Foxp3、IL-17mRNA。结果在停药随访24 w,联合组与恩替卡韦组血清HBV DNA阴转率分别为86.96%和84.78%(P>0.05);联合组血清HBeAg阴转率为28.89%(13/45),与恩替卡韦组的15.22%(7/46)比,无显著性差异(P>0.05);联合组血清ALT水平为(34.6±11.6)U/L,显著低于恩替卡韦组【(64.6±20.5)U/L,P<0.05】;联合组外周血CD3^+、CD4^+细胞和CD4^+/CD8^+比值分别为(75.6±14.5)%、(42.7±10.3)%和(1.4±0.6),显著高于恩替卡韦组【(66.8±14.4)%、(36.7±8.5)%和(1.0±0.5),P<0.05】,CD8+细胞百分比为(29.3±7.3)%,显著低于恩替卡韦组【(34.8±8.5)%,P<0.05】,两组NK细胞百分比比较无显著性差异(P>0.05);治疗前两组血清IL-6、IL-17、IL-4、INF-ɑ、TGF-β1水平比较无显著性差异(P>0.05),治疗后联合组血清IL-6水平为(6.8±1.2)pg/ml,显著高于恩替卡韦组【(3.5±0.8)pg/ml,P<0.05】,IL-17水平为(0.7±0.3)pg/ml,显著低于恩替卡韦组【(2.8±0.9)pg/ml,P<0.05】,IL-4水平为(1.4±0.5)pg/ml,显著低于恩替卡韦组【(3.8±1.5)pg/ml,P<0.05】,INF-ɑ水平为(4.0±1.3)pg/ml,显著高于恩替卡韦组【(2.6±0.9)pg/ml,P<0.05】,两组血清TGF-β1水平比较无显著性差异(P>0.05);治疗前两组血清Foxp3、IL-17和RORγt mRNA水平比较无显著性差异(P>0.05),治疗后联合组血清RORγt水平为(0.86±0.31),显著低于恩替卡韦组【(1.56±0.43),P>0.05】,而两组血清Foxp3和IL-17mRNA水平比较无显著性差异(P>0.05)。结论聚乙二醇干�Objective To investigate the effect of pegylated interferonα-2b on peripheral blood T lymphocyte subsets and serum cytokine levels in patients with chronic hepatitis B.Methods 184 patients with chronic hepatitis B were recruited in our hospital between January 2014 and January 2016,and 92 patients were treated with combination of pegylated interferonα-2b and entecavir for 48 weeks,and 92 cases were with entecavir alone.The liver function indexes,serum cytokines IL-6,INF-α,IL-17,IL-4 and TGF-β1,peripheral blood T lymphocyte subsets and nuclear transcription factor(Foxp3,RORγt,IL-17)mRNA were evaluated in all patients before and after treatment.Results At the end of 24 w follow-up after discontinuation of the regimen,serum HBV DNA negative rate in the combined group and entecavir group were 86.96%and 84.78%,respectively(P>0.05),and serum HBeAg negative rate in combined group was 28.89%(13/45),without significant difference as compared with that in entecavir group[15.22%(7/46),P>0.05];there were no significant differences before treatment between the two groups(P>0.05)as respect to serum TBIL,ALT,ALB levels and PTA,while serum ALT level in the combination group at the time of follow-up was(34.6±11.6)U/L,significantly lower than(64.6±20.5)U/L(P<0.05)in the entecavir group;before treatment,the percentage of CD3+,CD8+,CD4+cells and the ratio of CD4+/CD8+had no significant difference between the two groups(P>0.05),while after treatment,the percentage of CD3+,CD4+cells and the ratio of CD4+/CD8+in peripheral blood in combination group were(75.6±14.5)%,(42.7±10.3)%and(1.4±0.6),significantly higher than those in the entecavir group[(66.8±14.4)%,(436.7±8.5)%and(1.0±0.5),P<0.05];the percentage of CD8+cells was(29.3±7.3)%,significantly lower than that in the entecavir Group[(34.8±8.5)%,P<0.05];there was no significant difference between the two groups(P>0.05)as respect to the percentage of NK cells;before treatment,serum levels of IL-6,IL-17,IL-4,INF-αand TGF-β1 showed no significant differences between the t

关 键 词：慢性乙型肝炎 聚乙二醇干扰素Α-2B T淋巴细胞亚群 细胞因子 

分 类 号：R512.62[医药卫生—内科学]