乙醇对慢性丙型肝炎患者HCV基因型分布及肝损害的影响

Influence research on alcohol to genotype disposition of HCV and change of cytokines in HCV patients

目的:对比嗜酒与非嗜酒的慢性丙型肝炎(chronic hepatitis C,CHC)患者HCVRNA基因型及分布,以明确嗜酒的CHC患者病情发展是否与某种特定基因型有关。检测CHC患者IFN-γ及TNF-α水平,了解嗜酒的HCV感染者肝损害的机制。方法:收集CHC患者114名,分为嗜酒组和非嗜酒组,以基因芯片技术对2组患者进行HCVRNA基因分型。采用Ficoll梯度离心法提取所有患者外周血单个核细胞(PBMC)并培养,ELISA法检测IFN-γ及TNF-α的水平。结果:嗜酒组和非嗜酒组HCVRNA的基因型均以1b型为主(嗜酒组的比例为60%,非嗜酒组为43.75%),二者之间无统计学意义(P=0.22)。嗜酒组和非嗜酒组的HCVRNA定量测定分别为(11100±14174.3)×103mL-1和(3927.8±4549.6)×103mL-1,二者比较差异有统计学意义(P=0.025)。嗜酒组和非嗜酒组TNF-α水平分别为(4528±3587)ng/L和(3262±3131)ng/L,二者相比差异有统计学意义(P=0.048),但2组IFN-γ水平差异无统计学意义(P>0.05)。结论:乙醇促CHC肝患者HCVRNA复制,导致肝损伤加重,但并不能增加慢性HCV感染者对某种HCVRNA基因型的易感性。TNF-α在嗜酒的CHC患者中起重要作用,是导致肝损害的重要细胞因子之一。

Objective ： To analyze the genotypes of HCV RNA in alcoholic and nonalcoholic HCV patients and contrast the distribution of the genotypes between those, identifying whether alcoholic patients have a higher susceptibility to certain genotype than nonalcoholic patients, Meanwhile ,to detect the level of FN-γ and TNF-α for gaining the mechanism of hepatic lesion in alcoholic HCV patients. Method. 114 HCV patients, according to the history of alcohol abuse, were divided into the alcohol group and nonalcohol group. The genotypes of HCV RNA in the two groups were performed by gene chip technique. Liver biopsy was practiced in 30 patients to diagnose. Ficol gradient centrifugation and ELISA were used for extraction of PBMC and detection of IFN-γ and TNF-α ,respectively. Result ：The genotype lb was greater than other genotypes in the two groups, and there was no statistical significance （Alcohol group was 60% and nonalcohol group was 43.75% P=0.22）. The serum titers of HCV RNA of alcohol group were（1 1100 ± 14 174.3） × 10^3copies/ml and the nonalcohol group were （3 927.8 ± 4 549.6） × 10^3copies/ml,and there was statistical significance between the two groups （P=0.025）. Among 18 alcoholic patients of 30 patients practiced liver biopsy, their liver inflammation was higner than nonalcoholic patients. The level of TNF-α of the alcohol was higher than that of nonalcohol, there was statistical significance between the two groups （P=0.048） and no statistical significance between those of IFN-γ Conclusion： Alcohol can promote the copies of HCV RNA in HCV patients and aggravate liver injury, out can＇t add susceptibility to certain genotypes of HCV RNA The liver inflammation of alcoholic patients is higher than that of nonalco- holic patients TNF- α,which builds an mportant effect in alcoholic HCV patients is one of the important mechanisms in the liver injury