乙型病毒性肝炎患者外周血T辅助细胞1、2型细胞因子含量的测定及临床意义

The levels of T helper 1 and T helper 2 cytokines in peripheral blood of heptatitis B patients and their clinical significance

目的 探讨Th1、Th2细胞因子在乙型肝炎发病中的作用。方法 采用酶联免疫吸附法 (ELISA)检测 10例急性乙肝患者、35例慢性乙肝患者及 12例正常对照者外周血单个核细胞 (PBMC)在植物凝血素 (PHA)和脂多糖 (LPS)刺激下 ,产生白细胞介素 - 10 (IL - 10 ) ,γ -干扰素 (IFN -γ)及白细胞介素 - 12 (IL - 12 )的水平。结果 ①所有患者在PBMC培养上清液中 ,3种细胞因子的水平均显著高于正常对照 (P均 <0 .0 5 ) ;与慢性乙肝组相比 ,急性乙肝组IL - 10较低 (P <0 .0 1) ,而IFN -γ、IL - 12较高 (P <0 .0 5 ) ,慢性乙肝轻、中、重度 3组间呈现重度 >中度 >轻度 ,但是差异无显著性 (P均 >0 .0 5 )。②IL - 12、IFN -γ水平与血清丙氨酸氨基转移酶 (ALT)及总胆红素 (TBIL)呈正相关 (r =0 .6、0 .7,P均 <0 .0 1;r =0 .6、0 .6 ,P均 <0 .0 5 ) ;而与病毒含量呈负相关 (r =- 0 .75、-0 .73,P均 <0 .0 5 ) ;IL - 10与ALT、TBIL无相关性 (r=0 .0 3、0 .0 5 ,P 均 >0 .0 5 )。③Th2 /Th1比值 :与正常相比 ,慢性患者较高 ,急性患者较低 ,差异均有显著性 (P <0 .0 5 ) ;急性患者明显低于慢性患者 (P <0 .0 5 ) ;慢性轻度组高于慢性中、重度组 (P <0 .0 5 ) ,而后二组间无明显差别 (P >0 .1)。结论 Th2细胞因子与HBV感?

Objective To investigate the roles of Th1 and Th2 cytokines in the pathogenesis of hepatitis B (HB). Methods ELISA was used to determine the levels of IL-10, IFN-γ and IL-12 that were produced by the PHA or LPS-activated peripheral blood mononuclear cells (PBMC) in 35 chronic hepatitis B (CHB) patients,10 acute hepatitis B (AHB) patients and 12 age-matched normal controls (NC). Results ①The levels of the three cytokines in all of the HB patients were higher than that in the normal controls (P<0.05). The IL-10 level was markedly lower but the IFN-γ and IL-12 levels were higher in the AHB group than in the CHB group (P<0.05). Among the CHB patients, their cytokine levels stepped down with the severity of the disease in the order of severe>moderate>mild, but the differences were insignificant (P>0.05). ②The serum levels of ALT and TBIL in all patients were positively correlated to those of IL-12 and IFN-γ(r=0.6 and 0.7, P<0.01; r=0.06 and 0.06, P<0.05); while IL-10 had no such correlations (r=0.03 and 0.05,P>0.05). The serum level of HBV-DNA was negatively correlated to the levels of IL-12 and IFN-γ (r=-0.15 and -0.13,P<0.05).③The Th2/Th1 ratio was lower in AHB but higher in CHB than in NC significantly (P<0.05); was lower in AHB than in CHB (P<0.05); and was obviously higher in the mild than in the moderate and severe CHB groups (P<0.05), with the latter two showing no significant differences (P>0.1). Conclusion The Th2 cytokines are associated with the chronicity of HBV infection. Th1 cytokines are associated with the inflammatory activities in HB, and will help the clearance of HBV when the level of Th1 cytokines predominates that of Th2.