不同HBV DNA载量慢性乙型肝炎患者应用恩替卡韦后血清IFN-γ、IL-6变化及临床意义

The Changes and Significance of IFN-γ and IL-10 Serum Level after ETV Treatment in Patients with Chronic Hepatitis B of Different HBV DNA Loads

目的探讨不同HBV DNA载量的慢性乙型肝炎(CHB)患者应用恩替卡韦后血清IFN-γ、IL-10水平及其临床意义。方法选取2010年7月至2011年7月期间在我院感染科门诊就诊的CHB患者60例,根据检测的HBV DNA载量分为高载量组、中载量组、低载量组,各组20例。并选取同期健康对照组20例。抽取CHB患者治疗前及治疗后24周,以及健康对照组的血清,检测血清中丙氨酸氨基转移酶(ALT)水平;并用酶联免疫吸附试验(ELISA)检测血清水平。结果①ETV治疗24周后,ALT复常率为81.7%,HBV DNA阴转率为69.5%,HBAg阴转率为26.7%,应答率为91.7%,无应答率为8.3%;②CHB患者血清IFN-γ和IL-10水平均比对照组明显增高(P<0.05);③ETV治疗前高载量组IFN-γ含量降低,而IL-10的含量增高(P>0.05);④ETV治疗后24周的血清IFN-γ比治疗前明显增高(P<0.05),而IL-10水平比治疗前明显降低(P<0.05)。结论不同HBV DNA载量的CHB患者血清IFN-γ和IL-10水平存在差异,IFN-γ/IL-10水平可作为ETV治疗CHB疗效的参考指标。

Objective To explore the changes and significance of interferon-y （IFN-γ） or interleukin-10 （IL-10） serum levels after ETV treatment in patients with chronic hepatitis B （CHB） of different HBV DNA loads. Methods Sixty patients with CHB in our hospital from July 2010 to July 2011 were divided into high HBV DNA level group, middle HBV DNA level group and low HBV DNA level group based on the HBV DNA loads （20 cases in each group）, and 20 healthy volunteers at the corresponding period were selected as the control group. The blood serum of healthy volunteers and CHB patients （24 months before and after treatment） were collected to detect the alanine aminotransferase （ALT） level, and the serum IFN-γ and IL- 10 levels were analyzed by ELISA method. Results① After 24 weeks of ETV treatment, the ALT normalization rate was 81.7%, HBV DNA negative conversion rate was 69.5%, the HBAg negative conversion rate was 26.7%, response rate was 91.7%, and the non-response rate was 8.3%. ② The IFN-γ and 1L-10 levels in CHB patients were all higher than those in control group （P〈0.05）; ③ Before ETV treatment, the IFN-γ level in high HBV DNA level group was lower than that in low HBV DNA level group （P〈0.05）, and IL-10 level in High HBV DNA level group was higher than that in Low HBV DNA level group （P〈0.05）. ④ The IFN-γ level at 24 weeks after ETV treatment was higher than the baseline, and the IL-10 level was lower than the baseline （P〈0.05）. Conclusions There is difference of IFN-γ and IL-10 serum levels in different HBV DNA loads, and the IFN-γ / IL-10 value can be used for the judgment of therapeutic effects during ETV treatment.