CAJ | 학술논문

目的探讨Th17、Th1细胞在慢性丙型肝炎病毒感染患者外周血的表达情况及其与干扰素联合利巴韦林标准治疗快速应答的关系.方法收集31例慢性丙型肝炎(Chronic hepatitis C,CHC)接受干扰素联合利巴韦林标准剂量治疗患者的人口学资料(包括年龄、性别、体重指数等)、肝功能及治疗基线时外周血标本,并以11例健康志愿者为对照组.采用前瞻性实验研究方法,观察CHC治疗4周时获得快速病毒学应答情况,采用流式细胞术检测治疗基线时外周血单个核细胞中CD3+、CD8 -、IL-17+、Th17细胞和CD3+、CD8-、IFN-γ+、Th1细胞的比例.结果 CHC患者较健康对照者外周血中Th1水平下降,Th17水平上升；标准抗病毒治疗无快速应答组较健康对照组基线时Th1细胞水平明显下降,Th17细胞水平明显升高(P＜0.05).结论干扰素联合利巴韦林标准治疗CHC无快速应答者外周血Th1/Th17亚群失衡,Th1水平下调,Th17水平上调；治疗基线时高Th17水平及低Th1水平可能不利于产生快速病毒学应答.
목적 탐토Th17、Th1세포재만성병형간염병독감염환자외주혈적표체정황급기여간우소연합리파위림표준치료쾌속응답적관계.방법 수집31례만성병형간염(Chronic hepatitis C,CHC)접수간우소연합리파위림표준제량치료환자적인구학자료(포괄년령、성별、체중지수등)、간공능급치료기선시외주혈표본,병이11례건강지원자위대조조.채용전첨성실험연구방법,관찰CHC치료4주시획득쾌속병독학응답정황,채용류식세포술검측치료기선시외주혈단개핵세포중CD3+、CD8 -、IL-17+、Th17세포화CD3+、CD8-、IFN-γ+、Th1세포적비례.결과 CHC환자교건강대조자외주혈중Th1수평하강,Th17수평상승；표준항병독치료무쾌속응답조교건강대조조기선시Th1세포수평명현하강,Th17세포수평명현승고(P＜0.05).결론 간우소연합리파위림표준치료CHC무쾌속응답자외주혈Th1/Th17아군실형,Th1수평하조,Th17수평상조；치료기선시고Th17수평급저Th1수평가능불리우산생쾌속병독학응답.
Objective To investigate the expression of Th17/Th1cells in peripheral blood and its relationship with rapid virologic response (RVR) to the therapy with pegylated interferon (PEG-IFN)combined with rib(a)ivirin (RBV) in patients with chronic hepatitis C (CHC).Methods Thirty one CHC patients treated with PEG-IFN combined with RBV were enrolled,and the demographic and clinical data including age,gender,body mass index (BMI),results of biochemical parameters in serum and the peripheral blood samples at baseline were collected. Eleven healthy volunteers were enrolled as control group.The RVR in 4th week were observed by prospective experimental research method. The ratio of CD3 +,CD8 -,IL-17 +,Th17 and CD3 +,CD8-,IFN-γ+,Th1in peripheral blood mononuclear cells (PBMCs) were detected at baseline by flow cytometry.Results Compared to the healthy control group,the level of Th1cells was decreased and the level of Th17 cells was increased in patients with CHC.In non-RVR group of CHC,compared to the healthy control group,the level of Th1cells was decreased significantly,and the level of Th17 cells was increased significantly ( P ＜ 0.05 ). Conclusions There was Th1/Th17 subgroups imbalance in no-RVR CHC patients treated with PEG-IFN combined with RBV,the level of Th1cells was reduced,and the level of Th17 cells was increased.The high level of TH17 cells and low level of Th1cells at baseline may not be conducive to the RVR.