聚乙二醇干扰素α-2a治疗非活动性HBsAg携带者HBsAg清除与血清粒-巨噬细胞集落刺激因子水平的关系

Association between HBsAg clearance and serum level of granulocyte-macrophage colony stimulating factor in inactive HBsAg carriers receiving pegylated interferon alpha-2a

目的探讨聚乙二醇干扰素(PEG-IFN)α-2a治疗非活动性HBs Ag携带者(IHC)发生HBs Ag清除与血清粒-巨噬细胞集落刺激因子(GM-CSF)水平的关系。方法收集2013年1月-2016年1月就诊于首都医科大学附属北京佑安医院门诊的IHC患者20例,经PEG-IFNα-2a治疗24周后13例获得HBs Ag清除(R组),7例未获得HBs Ag清除(NR组)。用Luminex技术检测患者基线、治疗12周和治疗24周血清GM-CSF水平。同时检测11例健康人(HC组)血清GM-CSF水平。计量资料2组间比较采用t检验,多组间比较采用方差分析,进一步两两比较采用Bonferroni检验。计数资料组间比较采用χ2检验。结果 R组、NR组及HC组基线血清GM-CSF水平分别为(42.63±11.24)pg/ml、(46.77±10.52)pg/ml(11.97±3.85)pg/ml,3组之间比较差异具有统计学意义(F=4.482,P=0.02),R组与NR组GM-CSF水平均明显高于HC组(P值均<0.05)。PEG-IFNα-2a治疗后12周和24周,R组血清GM-CSF水平均明显高于NR组[(83.31±14.20)pg/ml vs(25.90±7.06)pg/ml,t=22.422,P<0.001;(32.34±8.06)pg/ml vs(9.43±2.45)pg/ml,t=17.782,P=0.001]。R组患者基线抗病毒治疗12周、24周时,血清GMCSF水平呈现先升高后下降趋势,3个时间点比较,差异有统计学意义(F=7.655,P=0.002)。NR组患者基线抗病毒治疗12周、24周时,血清GM-CSF水平呈明显下降趋势,3个时间点比较,差异有统计学意义(F=5.264,P=0.016)。结论 PEG-IFNα-2a治疗IHC过程中血清GM-CSF水平升高可能预示着HBs Ag清除。

Objective To investigate the association between HBsAg clearance and serum level of granulocyte-macrophage colony stimulating factor （GM-CSF） in inactive HBsAg carriers receiving pegylated interferon （PEG-IFN） alpha-2a.Methods A total of 20 inactive HBsAg carriers who visited Beijing YouAn Hospital,Capital Medical University,from January 2013 to January 2016 were enrolled,and after 24 weeks of PEG-IFN alpha-2a treatment,13 achieved HBsAg clearance （R group） and 7 did not achieve HBsAg clearance （NR group）.The Lurninex technique was used to measure the serum level of GM-CSF at baseline and at weeks 12 and 24 of treatment.The serum level of GM-CSF was also measured for 11 healthy controls （HC group）.The t-test or an analysis of variance was used for comparison of continuous data between groups,and the Bonferroni test was used for further comparison between two groups.The chi-square test was used for comparison of categorical data between groups.Results The R and NR groups had a significantly higher serum GM-CSF level than the HC group （42.63 ±11.24 pg/ml and 46.77 ± 10.52 pg/ml vs 11.97 ± 3.85 pg/ml）,and there was a significant difference between the three groups （F =4.482,P =0.02）.At weeks 12 and 24 of PEG-IFNα-2a treatment,the R group had a significantly higher serum GM-CSF level than the NR group （t =22.422 and 17.782,both P ＜0.05）.In the R group,the serum GM-CSF level was 42.63 ± 11.25 pg/ml at baseline,significantly increased to 83.31 ± 14.20 pg/ral at week 12 of treatment,and then significantly decreased to 32.34 ±8.06 pg/ml at week 24 of treatment （F=7.655,P =0.002）.In the NR group,the serum GM-CSF level was 46.77 ± 10.52 pg/ml at baseline and significantly decreased to 25.90 ± 7.06 pg/ml at week 12 of treatment and 9.43 ± 2.45 pg/ml at week 24 of treatment （F =5.264,P =0.016）.Conclusion In inactive HBsAg carriers receiving PEG-IFN alpha-2a treatment,the increase in serum GM-CSF level may indicate HBsAg clearance.