慢性乙型肝炎患者血清MIG的表达及核苷类似物对其的影响

Expression of Serum Chemokine MIG in Patients with Chronic Hepatitis B and Influence of Nucleoside Analogues Treatment

目的了解慢性乙型肝炎病毒感染患者体内趋化因子MIG(即IFN-γ诱导单核因子,又称CXCL9)的表达情况,并了解MIG水平与核苷类似物治疗的关系。方法通过ELISA方法检测98例慢性乙型病毒性肝炎(CHB)患者及72例健康对照者血清MIG水平,并检测32例CHB患者接受核苷类似物治疗前、治疗后3个月血清MIG水平。结果 CHB患者血清MIG水平明显高于健康对照组,差异有统计学意义(P<0.01)。CHB患者血清MIG水平与HBV-DNA定量(r=0.309 2,P<0.01)和血清ALT水平(r=0.390 4,P<0.01)呈现正相关,与肝脏结节改变、腹水、癌变相关(P<0.05)。CHB患者核苷类似物治疗3个月后血清MIG水平明显下降(P<0.05),并伴随HBV-DNA及ALT水平下降(P<0.01)。结论慢性HBV感染能诱导患者体内趋化因子MIG表达,其表达水平与病毒含量和肝脏的炎症程度密切相关,MIG可能成为预测慢性乙型病毒性肝炎疾病进展的重要指标之一。核苷类似物通过抑制病毒复制,下调趋化因子MIG表达,从而减轻炎症反应,延缓乙肝患者病情的进展。

Objective To investigate the expression of chemokine MIG（monokine induced by interferon-γ） in patients with chronic hepatitis B（CHB）and the alternation of MIG following nucleoside analogues treatment.Methods Serum MIG level in 98 patients with CHB and 72 healthy controls was detected by using enzyme-linked immunosorbent assay（ELISA）.The changes of serum MIG levels in 32 patients with CHB after nucleoside analogues treatment for 3 months were measured as well.Results Serum MIG level in CHB patients was significantly higher than that in healthy controls（P0.01）.Serum MIG level in CHB patients was positively correlated with serum HBV-DNA copies（r=0.309 2,P0.01）and ALT levels（r=0.390 4,P0.01）.It was also correlated with liver nodule changes,ascites,and malignant transformation（P0.05）.The expression of MIG was strikingly reduced after nucleoside analogues treatment for 3 months（P0.05）,accompanied by decreased serum HBV-DNA copies and ALT levels（P0.01）.Conclusion Chronic HBV infection induces chemokine MIG expression in vivo,and MIG level is closely related with HBV viral load and liver inflammation.MIG may be one of the important indicators to predict the disease progression of CHB.Nucleoside analogues can reduce chemokine MIG expression through inhibition of virus replication,thus lessen the inflammatory response,and palliate the development of hepatitis B.