慢性丙型肝炎患者血清sFas和sICAM-1及IL-18水平与意义

Serum levels of sFas, sICAM-1, IL-18 in patients with chronic hepatitis C and their clinical significance

目的 :观察可溶性 Fas(s Fas)和可溶性细胞间粘附分子 - 1(s ICAM- 1)及白细胞介素 - 18(IL- 18)在慢性丙型肝炎患者血清中的水平 ,探讨它们在丙型肝炎发病机制中的作用。方法 :采用 EL ISA法检测 30例慢性丙型肝炎患者 α-干扰素治疗前后血清 s Fas、s ICAM- 1、IL- 18的水平 ,荧光定量 PCR技术测定血清 HCV- RNA滴度。结果 :慢性丙型肝炎患者 s Fas、s ICAM- 1、IL- 18的水平均显著高于正常人 (P<0 .0 1) ,且与血清 HCV- RNA滴度密切相关(分别为 r=0 .915 ,r=0 .795 ,r=0 .75 7,P均 <0 .0 1) ;s ICAM- 1、IL- 18水平与 ALT活性显著相关 (分别为 r=0 .95 2 ,r=0 .96 9,P<0 .0 1) ,但 s Fas水平与 ALT无关 (P>0 .0 5 )。实验结果还显示 ,抗病毒治疗有效者 ,血清s Fas、s ICAM- 1、IL- 18较治疗前明显下降 ,而无反应者治疗前后改变不明显。结论 :s Fas、s ICAM- 1、IL- 18均参与慢性丙型肝炎免疫致病过程 ,且与肝脏炎症活动性。

Objective: To investigate the serum levels of soluble Fas antigen (sFas), soluble intercellular adhesion molecules 1 (sICAM 1), interleukin 18 (IL 18) in patients with chronic hepatitis C and to study their roles in pathogenesis of chronic hepatitis C. Methods: Serum sFas, sICAM 1, IL 18 levels were measured in 30 cases of chronic hepatitis C before and after treatment of interferon α by enzyme linked immunosorbent assay (ELISA), serum titer of HCV RNA was detected by quantitative PCR and serum ALT activity was also detected. Results: Serum levels of sFas?sICAM 1?IL 18 in chronic hepatitis C patients were significantly higher than those in normal controls ( P <0.01), showing correlation with serum HCV RNA titer ( r =0.915, r =0.795, r =0.757,respectively, P <0.01), Serum levels of sICAM 1,IL 18 showed correlation with serum ALT level ( r =0.952, r =0.969, respectively, P <0.01),but no relationship was observed between serum sFas and serum ALT level ( P >0.05 ). Serum levels of sFsa?sICAM 1?IL 18 markedly decreased in responsive patients while no change was observed in patients with no response after treatment. Conclusion: Soluble Fas, soluble ICAM 1, IL 18 may participate in the pathogenesis of chronic hepatitis C and show correlation with the severity of histological inflammation and viral titer.