人白细胞抗原DR及肿瘤坏死因子α与乙型肝炎病毒慢性感染结局关系探讨

Relationship study on HLA-DR and serum levels of TNF α and the outcomes in chronic hepatitis B virus infected patients

目的探讨人白细胞抗原DR(HLA-DR)及肿瘤坏死因子α(TNFα)与乙型肝炎病毒慢性感染结局的关系。方法对159例HBV慢性感染者HLA-DR基因型及血清TNFα水平的差异及相关性进行分析,其中慢性乙型肝炎(CHB)87例、乙型肝炎肝硬化(LC)38例、HBV相关肝细胞癌(HCC)34例。HLA-DR基因型检测采用PCR-SSP法,TNFα采用ELISA法检测。结果三组间HLA-DR13比较有统计学意义(P<0.05),LC组和HCC组均高于CHB组(P<0.01),LC组和HCC组间比较无统计学意义。其他HLA-DR基因型在三组间比较无统计学意义。三组间血清TNFα水平比较有统计学意义,LC组和HCC组均高于CHB组(P<0.01),LC与HCC间比较无统计学意义。携带HLA-DR13基因者与非携带者间血清TNFα水平比较无统计学意义。结论在HBV慢性感染者中,HLA-DR13基因和血清TNFα高水平可能是肝硬化和肝细胞癌的易发因素。

Objective To study the relationship between HLA-DR genotypes,serum levels of TNF α and the outcomes in chronic HBV infected patients.Methods To analyze the difference and relationship of HLA-DR genotypes and serum levels of TNF α in 159 cases of chronic HBV infected patients,including 87 patients with chronic hepatitis B,38 with liver cirrhosis and 34 with hepatocellular carcinoma.HLA-DR alleles were detected by PCR-SSP,serum TNF α levels were detected by ELISA assays.Results The frequencies of HLA-DR13 were significantly different among the three groups（P0.05）,which were significantly higher in LC and HCC groups than that in CHB group,but there were no significant differences between LC and HCC groups.Differences of the other HLA-DR genotypes among the three groups were not significant.Serum TNF α levels in LC and HCC groups were significantly higher than that in CHB group（P0.01）,but no significant differences between LC and HCC group.And serum TNF α levels were not significantly different between the HLA-DR13 carriers and non-carriers in chronic HBV infected patients.Conclusions HLA-DR13 genotypes and high serum TNF α levels may be the susceptive factors of LC and HCC in chronic HBV infected patients.