慢性丙型肝炎患者血浆IRF-3水平的变化及临床意义

Change and role of plasma IRF-3 level in patients with chronic hepatitis C

目的探讨慢性丙型肝炎(CHC)患者干扰素调节因子(IRF)-3水平的变化及其与丙型肝炎病毒(HCV)RNA载量、肝脏损伤程度及干扰素抗病毒疗效的关系。方法检测57例CHC患者抗病毒治疗前及26名体检健康者(正常对照组)血浆IRF-3、β-干扰素(IFN-β)水平,同时检测丙氨酸氨基转移酶(ALT)活性、Ⅳ型胶原(CⅣ)水平及HCV RNA载量。根据ALT、CⅣ和HCV RNA载量分别分组;根据抗病毒疗效分为应答组和无应答组。采用Spearman秩相关分析评估各项目之间的相关性。结果CHC组血浆IRF-3、IFN-β水平明显低于正常对照组(P<0.01)。ALT升高组与ALT正常组之间、CⅣ升高组与CⅣ正常组之间、HCV RNA高载量组与HCV RNA低载量组之间血浆IRF-3水平差异均有统计学意义(P<0.05)。Spearman秩相关分析结果显示,CHC患者IRF-3与IFN-β呈正相关(r=0.930,P<0.01),与HCV RNA载量、ALT、CⅣ均呈负相关(r值分别为-0.321、-0.290、-0.345,P<0.05)。应答组血浆IRF-3水平低于无应答组(P<0.05),血浆IFN-β水平2个组之间差异无统计学意义(P>0.05)。结论CHC患者血浆IRF-3水平与HCV RNA载量、肝细胞损伤程度及纤维化程度有关,对干扰素疗效的判断也有一定的价值。

Objective To investigate the changes of interferon regulatory factor(IRF)-3 level in patients with chronic hepatitis C(CHC)and its relationship with hepatitis C virus(HCV)RNA load,the degree of liver injury and antiviral efficacy of interferon.Methods The levels of IRF-3 and beta-interferon(IFN-β)were determined for 26 healthy subjects and 57 patients with CHC.The alanine aminotransferase(ALT)activity,typeⅣcollagen(CⅣ)level and HCV RNA load in plasma of CHC patients were also determined.According to the ALT activity,CⅣlevel,HCV RNA load and the efficacy of interferon therapy,the patients were classified into 2 groups.Spearman rank correlation analysis was used to evaluate the correlation among these parameters.Results The levels of plasma IRF-3 and IFN-βin CHC group were lower than those in healthy control group(P<0.01).The levels of plasma IRF-3 had statistical significance between high ALT activity group and normal ALT activity group,high CⅣlevel group and normal CⅣlevel group,high HCV RNA load group and low HCV RNA load group(P<0.05).Spearman rank correlation analysis showed that the IRF-3 level was positively correlated with IFN-βin CHC patients(r=0.930,P<0.01),and showed negative correlations with HCV RNA load,ALT activity and CⅣlevel(r values were-0.321,-0.290 and-0.345,respectively,P<0.05).The IRF-3 level in response group was lower than those in non-response group(P<0.05),and there was no statistical significance in IFN-βlevels between the 2 groups(P>0.05).Conclusions The level of plasma IRF-3 in CHC patients is related to HCV RNA load,the degree of hepatic cell damage and the degree of hepatic fibrosis,and it is valuable to judge the efficacy of IFN.