乙型肝炎不同白介素细胞因子的检测及其意义

Detection of serum interleukin-10,interleukin-13,interleukin-15 levels in patients with viral hepatitis B and their significance

目的探讨血清IL-10、IL-13、IL-15水平在乙型肝炎发生发展中的意义。方法采用双抗体夹心ELISA法检测2002年5月至2004年9月泉州市第一医院感染科109例乙型肝炎患者血清中IL-10、IL-13、IL-15水平。结果慢性肝炎中度患者血清IL-10、IL-13显著高于慢性重型肝炎、慢性肝炎重度、急性肝炎及正常对照组(P<0.01)。IL-15值比较,急性肝炎、慢性肝炎中度、慢性肝炎重度、慢性重型肝炎明显高于正常对照组(P<0.01)。IL-15/IL-10、IL-15/IL-13比值,慢性重型肝炎、慢性肝炎重度、急性肝炎明显高于慢性肝炎中度及正常对照组(P均<0.01)。慢性重型肝炎死亡组IL-15值及IL-15/IL-10、IL-15/IL-13比值明显高于治疗好转组(P<0.01)。结论乙型肝炎患者存在异常的细胞免疫应答,通过联合检测血清IL-10、IL-13、IL-15值及IL-15/IL-10、IL-15/IL-13比值,能较好地反映乙型肝炎患者Th1/Th2细胞激活状态,有助于不同临床类型的乙型肝炎患者的预后判断及指导治疗。

Objective To investigate the significance of the expression of intedeukin - 10 （IL - 10）, intedeukin - 13 （ IL - 13） and interleukin - 15 （IL - 15） in serums of patients with hepatitis B. Methods The expression of IL - 10, IL - 13 and IL - 15 in serums of 109 patients was measured by ELISA. Results The serum levels of IL - 10, IL - 13 in patients with moderate degree chronic hepatitis B （CHB） group were significantly higher than that in patients with chronic severe hepatitis group, severe degree CHB group, acute hepatitis group and normal group. The serum level of IL - 15 was increased in patients with acute hepatitis, moderate degree CHB group, severe degree CHB group and chronic severe hepatitis compared with normotensives. The proportion of IL- 15/IL- 10 and IL- 15/IL- 13 in patients with chronic severe hepatitis group, severe degree CHB group and acute hepatitis group were higher than that in patients with moderate degree CHB group and normotensives. The serum level of IL - 15 and the proportion of IL - 15/IL - 10 and IL - 15/IL - 13 in dead group were significantly higher than that in improving group with chronic severe hepatitis. Conclusion There is an abnormal cell - mediated immune response in patients with hepatitis B. Combining detection on the levels of serum IL- 10, 1L- 13 and IL -15, and the proportion of IL- 15/IL - 10 and IL -15/IL- 13 would nicely show the cellular active status and be helpful to the prediction of prognosis and direction of therapy in patients with hepatitis B of different kinds of clinical type.