Th细胞相关因子在慢性乙型肝炎患者中的表达及其临床意义

Expression and the clinical value of helper T lymphocyte in the patients with chronic HBV infection

目的探讨辅助性T细胞(Th1、Th2、Th17)在慢性乙型肝炎(CHB)发病过程中的作用。方法采用流式细胞小球微阵列术(cytometric bead array,CBA)检测36例慢性乙型肝炎(CHB组)、41例乙型肝炎肝硬化(LC组)患者和13例健康体检者[正常对照(NC)组]血清中Th的特征细胞因子INF-γ、IL-4和IL-17A水平及其比值,并比较3种细胞因子水平在LC Child-pugh分级中的作用;同时分析3种细胞因子水平与血清ALT、TBil、HBV DNA之间的相关性。结果 CHB组、LC组IL-4、IL-17A均明显高于NC组;CHB组、LC组INF-γ、IL-4、IL-17A三者之间的比值均低于NC组;IL-4、IL-17A水平与LC Child-pugh分级密切相关;3种细胞因子水平与血清ALT、TBIL、HBV DNA之间无相关性。结论 IL-4、IL-17A水平及Th细胞亚群失衡可能在CHB、LC患者病情的进展以及预后中起着重要作用;IL-4、IL-17A可作为LC程度的判断指标。

【Objective】To investigate the role of helper T lymphocyte（Th1, Th2, Th17） in the pathogenesis of chronic HBV infection. 【Methods】Specific cytokines of helper T lymphocyte such as INF-γ, IL-4, IL-17A in serum of 36 patients with chronic hepatitis B, 41 patients with chronic liver cirrhosis and 13 healthy examined people（as normal controls） were measured by Cytometric Bead Array. The level of three cytokines wasanalyzed and showed the relationship between the level and the class of child-pugh, ALT, TBil and HBV DNA copies.【Results】 The concentration of IL-4 and IL-17A of patients with chronic hepatitis B and chronic liver cirrhosis were higher than that of normal control. The ratio of INF-γ, IL-4, IL-17A of patients with chronic hepatitis B and chronic liver cirrhosis were lower than that of normal control. The level of IL-4, IL-17A was closely related to the class of childpugh. Three cytokines were non-correlated to ALT, TBil and HBV DNA copies.【Conclusion】The level of IL-4, L-17A and the imbalance of helper T lymphocyte subpopulations may play the important role in the progress and prognosis of chronic hepatitis B and liver cirrhosis. The level of IL-4, IL-17A can be used as a marker to determine the degree of liver cirrhosis.