Th1/Th2细胞因子表达水平对慢性乙型肝炎患者停用核苷(酸)类似物后复发的预测价值  

The Prognostic Value of Th1/Th2 Cytokine Expression in Patients with Chronic Hepatitis B after Discontinuation of Nucleoside(Acid)Analogues

作　　者：田晓晓 张娟 李琳彬[1,2] 赵小芬 刘力瑜 余焰[1,2] TIAN Xiao-Xiao;ZHANG Juan;LI Lin-Bin;ZHAO Xiao-Fen;LIU Lu;YU Yan(Clinical Laboratory of Chongqing Hospital of Traditional Chinese Medicine,Chongqing 400021,China;Chongqing-Sichuan Joint Laboratory for Integrative Research and Treatment of Infectious Diseases,Chongqing 400021,China)

机构地区：[1]重庆市中医院检验科,重庆400021 [2]川渝共建感染性疾病中西医结合诊治重庆市重点实验室,重庆400021

出　　处：《中国药物经济学》2024年第12期59-63,67,共6页China Journal of Pharmaceutical Economics

摘　　要：目的探讨Th1/Th2细胞因子表达水平对慢性乙型肝炎患者停用核苷(酸)类似物后复发的预测价值。方法选取2022年10月至2024年3月重庆市中医院收治的慢性乙型肝炎患者180例作为研究对象,根据停用核苷(酸)类似物半年后是否复发而将其分为复发组(52例)和非复发组(128例)。180例慢性乙型肝炎患者停用核苷(酸)类似物半年后均进行血清Th1/Th2细胞因子表达水平检测,比较两组血清Th1细胞因子[白细胞介素-2(IL-2)、干扰素-γ(IFN-γ)]和Th2细胞因子[白细胞介素-4(IL-4)、白细胞介素-5(IL-5)]水平,比较两组患者临床资料,并分析患者血清Th1/Th2细胞因子表达水平及相关临床资料在预测慢性乙型肝炎患者停用核苷(酸)类似物后复发情况的临床价值。结果两组合并脂肪肝和吸烟情况及血清Th1细胞因子(IL-2、IFN-γ)水平、Th2细胞因子(IL-4、IL-5)水平比较,有显著性差异(P<0.05);二元Logistics回归分析结果显示,患者合并脂肪肝、吸烟、血清Th1细胞因子(IL-2、IFN-γ)水平、Th2细胞因子(IL-4、IL-5)水平是慢性乙型肝炎患者停用核苷(酸)类似物后复发的独立影响因素(P<0.05);工作特征曲线分析,总预测模型曲线下面积(AUC)为0.859,95%CI(0.799~0.920),灵敏度为0.712,特异度为0.859;Th1/Th2预测模型曲线AUC为0.837,95%CI(0.778~0.897),灵敏度为0.827,特异度为0.720。结论合并脂肪肝、吸烟及血清Th1/Th2细胞因子表达水平是慢性乙型肝炎患者停用核苷(酸)类似物后复发的危险因素,对慢性乙型肝炎患者采用血清Th1/Th2细胞因子表达水平进行预测有较好的临床价值。Objective To explore the prognostic value of Th1/Th2 cytokine expression in patients with chronic hepatitis B after discontinuation of nucleoside(acid)analogues.Methods A total of 180 patients with chronic hepatitis B admitted to Chongqing Hospital of Traditional Chinese Medicine from October 2022 to March 2024 were selected as the study objects,and were divided into a relapsing group(52 cases)and a non-relapsing group(128 cases)according to whether the patients relapsed after stopping nucleoside(acid)analogues for half a year.Serum Th1/Th2 cytokine expression levels were examined in 180 patients with chronic hepatitis B after six months of disusing nucleoside(acid)analogues.Serum Th1 cytokine[interleukin-2(IL-2),interferon-γ(IFN-γ)]Th2 cytokine[interleukin-4(IL-4),interleukin-5(IL-5)]levels of the two groups were compared,and clinical data of the two groups were compared.The clinical value of serum Th1/Th2 cytokine expression and related clinical data in predicting the recurrence of chronic hepatitis B patients after discontinuation of nucleoside(acid)analogues was analyzed.Results There were significant differences in the status of fatty liver and smoking,serum Th1 cytokines(IL-2,IFN-γ)and Th2 cytokines(IL-4,IL-5)between 2 groups(P<0.05).The results of binary logistics regression analysis showed that patients with fatty liver,smoking,serum Th1 cytokine(IL-2,IFN-γ)levels,Th2 cytokine(IL-4,IL-5)levels were independent influencing factors for recurrence of chronic hepatitis B patients after discontinuation of nucleoside(acid)analogues(P<0.05).By analyzing the working characteristic curves,the AUC of the total prediction model was 0.859,95%CI(0.799~0.920),the sensitivity was 0.712,and the specificity was 0.859.The AUC of Th1/Th2 prediction model was 0.837,95%CI(0.778~0.897),sensitivity was 0.827,and specificity was 0.720.Conclusion Patients with fatty liver disease,smoking and serum Th1/Th2 cytokine expression level are risk factors for recurrence of chronic hepatitis B patients after discontinuation of nucleos

关 键 词：TH1/TH2细胞因子 慢性乙型肝炎 核苷(酸)类似物 停药复发 预测价值 

分 类 号：R575.1[医药卫生—消化系统] R978.7[医药卫生—内科学]