拉米夫定对慢性乙型肝炎患者血清IFN-γ、IL-4的影响

Effect of lamivudine on levels of serum IFN-γ and IL-4 in patients with chronic hepatitis B.

目的观察拉米夫定治疗慢性乙型肝炎过程中血清γ-干扰素(IFN-γ)、白细胞介素4(IL-4)等细胞因子的动态变化。方法用酶联免疫吸附(ELISA)方法分别检测117例慢性乙型肝炎患者在拉米夫定治疗前,治疗后第13、26、39、52周时的血清IFN-γ和IL-4水平。结果拉米夫定治疗后完全应答组IFN-γ/IL-4水平接近或高于对照组;部分应答组和无应答组IFN-γ/IL-4水平则低于对照组。结论拉来夫定治疗慢性乙型肝炎过程中,随着治疗时间的延长,乙型肝炎患者Th1类细胞因子IFN-γ水平逐渐增高;Th2类细胞因子IL-4水平逐渐降低,提示拉米夫定治疗慢性乙型肝炎不但抑制病毒繁殖,而且长时间治疗可增强Th1类细胞优势应答,抑制Th2类细胞功能。

Objective To investigate changes in serum IFN -γand IL- 4 levels of patients with chronic hepatitis B during lamivudine treatment. Methods Serum INF -γand IL- 4 levels were determined by ELISA in 117 patients with chronic hepatitis B at baseline and 13, 26, 39 and 52 weeks after treatment. Results The ratios of IFN -γto IL - 4 in complete response patients were approximate to or higher than those of control group. The ratios of IFN -γto IL -4 in partial response and non response patients were lower than those of control group. Conclusion In the course of lamivudine treatment, IFN -γ（ cytokines of Thl type ） levels gradually increased and IL-4 （cytokines of Th2 type ） levels gradually decreased in chronic hepatitis B patients, which suggest that long - term lamivudine treatment not only inhibit HBV replication but also enhance expression of cytokines of Thl type and inhibit expression of cytokines of Th2 type.