乙型病毒性肝炎患者血清IFN-γ、IL-10、TGF-β1检测的临床意义

Clinical significance of detecting the serum levels of IFN-γ,IL-10,TGF-β1 in patients with viral hepatitis B

目的评价乙型病毒性肝炎患者血清IFN-γ、IL-10、TGF-β1水平测定的临床意义。方法采用酶联免疫吸附法测定70例急、慢性乙型肝炎及肝硬化患者血清IFN-γ、IL-10、TGF-β1水平,并检测肝功能、肝纤维化以及HBV-DNA指标;以健康人18例为正常对照组。结果随着患者病情的加重和肝纤维化的进展,血清IFN-γ水平逐渐下降,而IL-10和TGF-β1水平则逐渐上升。血清IFN-γ水平与TBIL、PCⅢ、CⅣ、HA和LN呈显著负相关,而与ALB和PTA呈显著正相关;血清IL-10水平与TBIL、HA呈显著正相关,而与ALB和PTA呈显著负相关;血清TGF-β1水平与TBIL、PCⅢ、CⅣ、HA和LN呈显著正相关,而与ALB和PTA呈显著负相关(P<0.01)。HBV-DNA阳性患者肝纤四项水平显著高于阴性患者(P<0.05或<0.01)。结论 IFN-γ、IL-10、TGF-β1不仅与肝细胞损伤有良好的相关性,而且与肝纤维化的形成密切相关。因此,测定这些细胞因子水平,在监测慢性乙型肝的发生发展、肝纤维化进展程度以及评价治疗效果及预后具有重要的实用价值。

Objective To evaluate the clinical significance of detecting the serum levels of IFN-γ,IL-10,TGF-β1 in the patients with viral hepatitis B.Methods 70 patients with AHB,CHB and 18 healthy subjects were enrolled in the study.The serum levels of IFN-γ,IL-10,TGF-β1 were detected by enzyme linked immunosorbant assay（ELISA）,and liver function,liver fibrosis markers,HBV-DNA were measured simultaneously.Results With the aggravation of patient＇s condition and progress of hepatic fibrosis,the serum levels of IFN-γ were gradually decreased,however,the serum levels of IL-10 and TGF-β1 were gradually increased.The serum levels of IFN-γ were negatively correlated with those of TBIL,PCⅢ,CⅣ,HA and LN,however,which were positively related with those of ALB and PTA.The serum levels of IL-10 were positively correlated with those of TBIL,HA,however,which were negatively related with those of ALB and PTA.The serum levels of TGF-β1 were positively correlated with those of TBIL,PCⅢ,CⅣ,HA and LN,however,which were negatively correlated with those of ALB and PTA（P0.01）.The levels of four parameters about hepatic fibrosis in patients with positive HBV-DNA were significantly higher than those of patients with negative HBV-DNA（P0.05 or 0.01）.Conclusion The levels of IFN-γ,IL-10,TGF-β1 are not only correlated with hepatocellular damage,however,which were related with the formation of hepatic fibrosis.Therefore,the detection of serum levels of these cytokines plays an important role in monitoring the pathogenesis of chronic hepatitis B and progress of hepatic fibrosis,and in evaluating the therapeutic effect and patients＇ prognoses.