应用聚乙二醇干扰素α-2a联合利巴韦林治疗慢性丙型肝炎患者血清sVAP-1和SAA水平变化及其临床意义探讨

Implication of serum sVAP-1 and SAA levels in patients with chronic hepatitis C receiving pegylated interferonα-2a and ribavirin standardized treatment

目的探讨应用聚乙二醇干扰素α-2a联合利巴韦林治疗的慢性丙型肝炎(CHC)患者血清可溶性血管黏附蛋白-1(sVAP-1)和血清淀粉样蛋白A(SAA)水平变化及其临床意义。方法2018年2月~2021年2月我院收治的CHC患者62例和同期体检者48例,CHC患者均接受聚乙二醇干扰素α-2a联合利巴韦林治疗24周。采用ELISA法检测血清sVAP-1和SAA水平,采用实时荧光定量PCR法检测血清HCV RNA载量。采用早期病毒学应答(EVR)、治疗结束时病毒学应答(ETVR)和持续病毒学应答(SVR)考核疗效。结果CHC患者血清sVAP-1和SAA水平分别为(164.0±29.3)μg/L和(3.0±0.6)mg/L,显著高于健康人【分别为(73.7±15.8)μg/L和(0.8±0.2)mg/L,P<0.05】;17例血清高载量CHC患者血清sVAP-1和SAA水平分别为(225.9±33.7)μg/L和(4.3±0.7)mg/L,显著高于26例中等等HCV RNA载量患者【分别为(156.7±28.4)μg/L和(3.0±0.5)mg/L,P<0.05】或19例低HCV RNA载量患者【分别为(118.7±22.0)μg/L和(1.8±0.3)mg/L,P<0.05】;获得病毒学应答患者血清SAA水平显著高于未获得应答患者【EVR:(4.1±0.7)mg/L对(2.2±0.5)mg/L,ETVR:(3.2±0.9)mg/L对(1.6±0.4)mg/L和SVR:(3.7±0.8)mg/L对(1.5±0.4)mg/L,P<0.05】,而应答与未应答患者血清sVAP-1水平无显著性差异(P>0.05)。结论CHC患者血清sVAP-1和SAA水平升高,其变化与病毒复制水平可能有关。监测血清SAA水平变化或有助于预测CHC患者的抗病毒疗效。

Objective The aim of this study was to explore the implication of serum soluble vascular adhesion protein-1(sVAP-1)and serum amyloid A(SAA)levels in patients with chronic hepatitis C(CHC)receiving pegylated interferonα-2a(peg-IFN-α-2a)and ribavirin standardized treatment.Methods 62 patients with CHC and 48 healthy persons were enrolled in our hospital between February 2018 and February 2022,and all patients with CHC were treated with peg-IFNα-2a and ribavirin for 24 weeks.Serum sVAP-1 and SAA levels were detected by ELISA,and serum HCV RNA load was detected by real-time fluorescence quantitative PCR.The virologic response was evaluated by early virologic response(EVR),end treatment virologic response(ETVR)and sustained virologic response(SVR).Results Serum sVAP-1 and SAA levels in patients with CHC were(164.0±29.3)μg/L and(3.0±0.6)mg/L,significantly higher than[(73.7±15.8)μg/L and(0.8±0.2)mg/L,P<0.05]in healthy persons;serum sVAP-1 and SAA levels in 17 CHC patients with high serum viral loads were(225.9±33.7)μg/L and(4.3±0.7)mg/L,significantly higher than[(156.7±28.4)μg/L and(3.0±0.5)mg/L,respectively,P<0.05]in 26 CHC patients with medium viral loads or[(118.7±22.0)μg/L and(1.8±0.3)mg/L,respectively,P<0.05]in 19 CHC patients with low viral loads;serum SAA levels in patients who responded to antiviral therapy were significantly higher than non-responders[EVR:(4.1±0.7)mg/L vs.(2.2±0.5)mg/L;ETVR:(3.2±0.9)mg/L vs.(1.6±0.4)mg/L and SVR:(3.7±0.8)mg/L vs.(1.5±0.4)mg/L,P<0.05],while there were no significant differences as respect to serum sVAP-1 levels between responders and non-responders(P>0.05).Conclusion Serum sVAP-1 and SAA levels in patients with CHC increase,and their changes are related to virus replication.It might be helpful by monitoring serum SAA level changes in predicting the antiviral efficacy in patients with CHC.