慢性肝病患者血清细胞因子变化与临床意义

Study on relationship among cytokine level change in the sera of patients with chronic viral hepatic disease, viral replication and clinical significance

目的：为探讨慢性乙型肝炎病毒性肝病患者血清细胞团子TNF-α、IL-1、IL-6、IL-8活性变化及其在慢性肝病发生发展中的作用及临床意义。方法：采用ELISA法对慢性乙型肝炎（CH）、慢性乙型重型肝炎（CSH）、乙型肝炎性肝硬化（HC）患者血清中细胞因子TNF-α、IL-1、IL-6、IL-8活性进行了测定。结果：慢肝患者血清INF-α、IL-1、IL-6、IL-8水平明显高于健康对照组（P＜0．01）；以上4种细胞因子活性与不同临床类型的慢肝患者血清胆红素含量平行测定二者呈正相关；HBV-DNA或HBeAg阳性患者上述细胞因子活性明显高于HBV-DNA、HBeAg阴性患者（P＜0．01）。结论：慢性病毒性肝病患者机体存在免疫功能调控失衡；细胞因子活性与血清胆红素同样可反映肝细胞损伤程度；细胞因子TNF-α、IL-1、IL-6、IL-8活性与患者HBV携带状态即HBV的活跃程度有关。

Objective: To observe relationship among cytokine level change in the sera of patients with chronic viral hepatic disease, viral replication and clinical significance. Methods: The TNF-α, IL-1, IL-6 and IL-8 activities in the sera of patients with chronic hepatitis B (CH), chronic severe hepatitis B (CSH) and hepatocirrhosis (HC) by ELISA. Results:The TNF-α, IL-1, TL-6 and IL-8 activities of the patients with chronic viral hepatic diseases were significantly higher than those of healthy persons (P<0.01). The bilirubin level in the sera of patients with chronic viral hepatic disease of different clinical types had a parallel relationship with the cytokine activities. The activites in the sera of HBV-DNA and HBeAg positive patients were significantly higher than those of negative patients (P < 0.01). Conclusion: The patients with chronic viral hepatic diseases had an unbalance on the regultion and control of immunologic function. The activities of cytokine as also as the bilirubin level in the sera of patients can reflect the necrosis degree of liver cells.The cytokine TNF-α, IL-1,IL-6 and IL-8 activities were related to the state of HBV carrier or the active degree of HBV.