慢性乙型肝炎病毒感染患者血清免疫调节因子检测的临床意义

Clinical significance of detection of serum immunoregulatory factors in patients with chronic hepatitis B virus infection

目的分析血清白细胞介素-4(IL-4)、IL-12及干扰素-γ受体(IFN-γ)3种细胞免疫调节因子在慢性乙型肝炎病毒(HBV)感染患者血清中的水平,了解慢性HBV感染患者的免疫功能,以探索治疗慢性乙型肝炎病毒治疗的新途径。方法选取2014年2月-2015年4月在医院就诊的51例慢性HBV感染患者作为研究对象,51例患者按HBV感染后临床表现分为慢性HBV携带组10例,慢性乙型肝炎组18例,乙型肝炎肝硬化组23例,选取同期17名健康体检者作为对照组;采用双抗体夹心法ELISA检测血清中IL-4、IL-12及IFN-γ水平,检测丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)及血清白蛋白(ALB)等代表肝细胞损伤程度的指标;采用SPSS17.0软件对数据进行统计分析。结果 HBV携带组、慢性乙型肝炎组和肝炎肝硬化组患者中IL-4、IL-12及IFN-γ水平均显著高于对照组,组间比较差异有统计学意义(P<0.05);对照组IFN-γ/IL-4的水平显著高于其他3组,差异有统计学意义(P<0.05);HBV携带组及肝炎肝硬化组患者IFN-γ/IL-4的水平显著低于慢性乙型肝炎组,差异有统计学意义(P<0.05);HBV携带组与肝炎肝硬化组间差异无统计学意义。结论通过测定HBV的某些细胞因子水平,对监测HBV感染疾病的发生及发展具有重要意义,对评价其治疗及预后具有重要的实用价值。

OBJECTIVE To detect the levels of three kinds of cellular immune regulatory factors in the serum of the patients with hepatitis B virus（HBV）infections,including the serum interleukin-4（IL-4）,IL-12,and interferon-γ（IFN-γ）receptor and understand the immune function of the patients with chronic HBV infection so as to explore new approach for the antiviral therapy.METHODS A total of 51 patients with chronic HBV infection who were treated in the hospital from Feb 2014 to Apr 2015 were enrolled in the study and divided into the chronic HBV-positive group with 10 cases,the chronic hepatitis B group with 18 cases,and the hepatitis B liver cirrhosis group with 23 cases according to the clinical manifestations;meanwhile,17 healthy people who received the physical examination were chosen as the control group.The levels of serum IL-4,IL-12,and IFN-γwere determined by using double antibody sandwich method ELISA,and the indicators reflecting the damage degree of liver cells such as alanine aminotransferase（ALT）,total bilirubin（TBIL）,and albumin（ALB）were detected;the statistical analysis of data was performed with the use of SPSS17.0software.RESULTS The levels of serum IL-4,IL-12,and IFN-γwere significantly higher in the HBV-positive group,the chronic hepatitis B group,and the hepatitis B liver cirrhosis group than in the control group（P〈0.05）;the IFN-γ/IL-4level of the control group was significantly higher than that of other three groups（P〈0.05）;the IFN-γ/IL-4of the HBV-positive group and the hepatitis B liver cirrhosis group was significantly lower than that of the chronic hepatitis B group（P〈0.05）;there was no significant difference between the HBV-positive group and the hepatitis B liver cirrhosis group.CONCLUSION The detection of the levels of certain HBV cytokines has great significance in surveillance of the occurrence and development of HBV infection and has practical value in evaluation of the therapeutic effect and prognosis.