CAJ | 학술논문

目的观察慢性乙型肝炎(CHB)患者外周血辅助性T细胞因子水平在抗病毒治疗过程中的变化,进一步探讨其与CHB发病的关系.方法在33例CHB患者采用恩替卡韦抗病毒治疗过程的不同时期,采用ELISA法检测其外周血IL-2、IL-6、IL-10、IFNγ和TNF-α水平,并同时检测患者肝功能.治疗前后细胞因子水平比较采用单因素方差分析,细胞因子水平变化与ALT、HBVDNA水平间行相关性分析.结果 IFNγ水平在治疗前及治疗12、24、48周分别为(5.98±2.77)、(5.95±3.37)、(2.93±2.15)、(9.29±4.65)pg/mL(F=3.845,P＜0.05),与ALT呈正相关(r=0.396,P＜0.05)；TNF-α及IL-10治疗前后呈逐渐下降趋势,各时期间差异有统计学意义(F=20.156,16.695；均P＜0.05),与ALT均呈正相关(r=0.354,0.316；均P＜0.05),与HBV DNA也均呈正相关(r=0.382,0.386;均P＜0.05)；IL-2、IL-6治疗前后各时期间差异无统计学意义(F=0.010,0.932；均P＞0.05).治疗前及治疗后各时期ALT、HBV DNA水平间差异有统计学意义(F=17.69,198.98；均P＜0.05),均随抗病毒治疗时间的延长逐渐降低,且两者间呈正相关(r=0.581,P＜0.05).结论 IL-10、IFNγ、TNF-α等细胞因子可能参与CHB病理过程,并与肝炎的病情变化密切相关,抗病毒过程中检测其血浆浓度有助于了解机体免疫情况,评价抗病毒药物疗效.
목적 관찰만성을형간염(CHB)환자외주혈보조성T세포인자수평재항병독치료과정중적변화,진일보탐토기여CHB발병적관계.방법 재33례CHB환자채용은체잡위항병독치료과정적불동시기,채용ELISA법검측기외주혈IL-2、IL-6、IL-10、IFNγ화TNF-α수평,병동시검측환자간공능.치료전후세포인자수평비교채용단인소방차분석,세포인자수평변화여ALT、HBVDNA수평간행상관성분석.결과 IFNγ수평재치료전급치료12、24、48주분별위(5.98±2.77)、(5.95±3.37)、(2.93±2.15)、(9.29±4.65)pg/mL(F=3.845,P＜0.05),여ALT정정상관(r=0.396,P＜0.05)；TNF-α급IL-10치료전후정축점하강추세,각시기간차이유통계학의의(F=20.156,16.695；균P＜0.05),여ALT균정정상관(r=0.354,0.316；균P＜0.05),여HBV DNA야균정정상관(r=0.382,0.386;균P＜0.05)；IL-2、IL-6치료전후각시기간차이무통계학의의(F=0.010,0.932；균P＞0.05).치료전급치료후각시기ALT、HBV DNA수평간차이유통계학의의(F=17.69,198.98；균P＜0.05),균수항병독치료시간적연장축점강저,차량자간정정상관(r=0.581,P＜0.05).결론 IL-10、IFNγ、TNF-α등세포인자가능삼여CHB병리과정,병여간염적병정변화밀절상관,항병독과정중검측기혈장농도유조우료해궤체면역정황,평개항병독약물료효.
Objective To determine the changes of peripheral levels of T helper cell cytokines of patients with chronic hepatitis B (CHB) during antiviral treatment,and to further explore its clinical significance.Methods The plasma levels of interleukin (IL)-2,IL-6,IL-10,interferon (IFN)-γ and tumor necrosis factor(TNF)-α of thirty-three CHB patients during antiviral treatment (entecavir) were measured using enzyme linked immunosorbont assay (ELISA).And their biochemical indicators of liver function were determined.The differences of cytokines levels before and after antiviral treatment were compared using ANOVA.The correlations between the changes of cytokines and alanine transaminase (ALT),hepatitis B virus (HBV) DNA levels were analyzed.Results Levels of IFNγ before and 12,24,48 weeks after treatment were (5.98±2.77),(5.95±3.37),(2.93±2.15) and (9.29±4.65) pg/mL,respectively (F=3.845,P＜0.05),which were positively correlated with ALT levels (r =0.396,P＜0.05).Both TNF-α and IL-10 levels declined after antiviral treatment,which were significantly different at different time points (F=20.156 and 16.695,respectively; both P＜0.05),and both levels of TNF-α and IL-10 were positively correlated with ALT levels (r=0.354and 0.316,respectively; both P＜0.05) and positively correlated with HBV DNA levels (r=0.382and 0.386,respectively; both P＜0.05).While both IL-2 and IL-6 levels were not significantly different between before and after antiviral treatment (F=0.010 and 0.932,respectively; both P＞0.05).The serum levels of ALT and HBV DNA before and after antiviral treatment were all significantly different (F=17.69 and 198.98,respectively; both P＜0.05),which declined gradually during treatment and were positively correlated (r =0.581,P＜0.05).Conclusions IL-10,IFNγand TNF-α may be involved in the pathologic process of CHB,and closely related to the deterioration of the disease.Monitoring plasma levels of these cytokines during antiviral treatment could be useful to understand the immune status and evaluate the efficacy of antiviral drugs.