α干扰素治疗慢性乙型肝炎早期外周血T淋巴细胞亚群和血清肝纤维化指标的变化

The change of peripheral blood T lymphocyte subsets and hepatic fibrosis indexes in the early stage of interferon α treatment in patients with chronic hepatitis B.

目的 研究IFNα治疗慢性乙型肝炎患者早期阶段外周血T淋巴细胞亚群及血清肝脏纤维化指标的变化,判断这些指标早期预测IFNα疗效的价值。方法 2 0 0 0年～2 0 0 3年收治的5 6例慢性乙型肝炎患者接受IFNα1b治疗6个月,于治疗前及治疗3个月时分别检测外周血T淋巴细胞亚群及血清肝脏纤维化指标。结果 IFNα治疗应答组和无应答组治疗前的CD3 + 、CD4+ 、CD8+ 及CD4+ /CD8+ 比值并无显著性差异(P >0 .0 5 )。应答组治疗前血清丙氨酸氨基转移酶及透明质酸水平要高于无应答组(P <0 .0 5 )。IFNα治疗3个月后,应答组HA、CD3 + 、CD4+ 及CD4+ /CD8+ 比值均较治疗前有显著提高(P <0 .0 5 ) ,而无应答组无这种现象(P >0 .0 5 )。结论 IFNα治疗早期阶段CD4+ 、CD4+ /CD8+ 比值及血清HA显著升高可以作为预测IFNα持续应答的指标。

Objective To study the change of peripheral blood T lymphocyte subsets and hepatic fibrosis indexes in the early stage of interferon α treatment in patients with chronic hepatitis B,and to detect the value of these indexes in predicting the curative effect of interferon α treatment early.Methods 56 patients with hepatitis B hospitalized from 2000～ 2003 were treated with interferon α for 6 months, the peripheral blood T lymphocyte subsets and hepatic fibrosis indexes were checked before interferon α treatment and in the 3rd month of treatment.Results The change of the counts of T lymphocyte subsets CD3 +、CD4 +、CD8 + and the ratio of CD4 +/ CD8 + in interferon α response group(IFN-RG) and interferon α nonresponse group(IFN-NRG)before treatment was not significant (P>0.05).The levels of serum ALT and HA in IFN-RG were higher than those in IFN-NRG (P<0.05).The levels of serum HA、CD3 +、CD4 + and the ratio of CD4 +/ CD8 + in IFN-RG were higher than before (P<0.05),after treated with interferon α for 3 months,and this phenomenon did not occur in IFN-NRG.Conclusion The significant improvement of CD4 +、CD4 +/ CD8 + and serum HA in the early stage of interferon α treatment can be used to predict the response of interferon α treatment.