慢性丙型肝炎血清IL-2、TNF及丙肝病毒基因型与干扰素疗效的关系

The Response to IFN Therapy in CHC Patients Varies with Their HCV Genotype and Pretreatment Serum IL_2 and TNF Levels

应用放射免疫法及 HCV- RNA NS5 酶切分型法检测 48例慢性丙型肝炎患者血清中 IL - 2、TNF及 HCV基因型 ,并以 2 0例健康人为正常对照。结果显示 :HCV基因型 型的慢性丙型肝炎干扰素疗效 (显效率 2 3% )差于 型(显效率 80 % ) (P<0 .0 5 ) ;慢性丙型肝炎患者干扰素治疗无效组 IL- 2水平 [(2 .5 3± 0 .5 7) ng/ ml]低于显效组 [(3.6 8± 0 .84) ng/ ml](P<0 .0 5 ) ;慢性丙型肝炎患者干扰素治疗显效组 TNF水平 [(3.15± 0 .77) ng/ ml]与无效组[(3.47± 1.10 ) ng/ ml]相仿 (P>0 .0 5 )。提示 :HCV基因型及 IL - 2可能影响干扰素的疗效 ;TNF不影响干扰素的疗效。

The pretreatment serum IL 2 and TNF levels were detected by using radioimmunoassay and HCV genotypes analyzed by digesting HCV RNA NS5 region with restriction enzyme in 48 patients with chronic hepatitis C and 20 healthy subjects as control group. After 6 month IFN therapy, a sustained response was observed in 23 % patients with genotype Ⅱ and 80 % patients with genotype Ⅲ ( P <0 05). The levels of pretreatment serum IL 2 in the patients with sustained response was significantly higher than those in the patients without sustained response (3 68±0 84 ng/ml vs 2 53±0 07 ng/ml, P<0 05). Mean pretreatment serum TNF levels were 3 15±0 77 ng /ml and 3 47±1 10 ng/ml in the patients with sustained response and without sustained response, respectively ( P >0 05). No difference in TNF level was found between sustained response group and non sustained response group. The results suggest that pretreatment serum IL 2 levels and HCV genotype might affect the outcome of IFN therapy, but the pretreatment serum TNF levels dit not influence the response to IFN therapy.