丙肝感染不同时期血清Th1/Th2型细胞因子表达及预测价值

Expression and predictive value of serum Th1/Th2 cytokines in different periods of hepatitis C infection

目的丙型肝炎病毒(HCV)感染不同时期血清辅助性T1型(Th1)/辅助性T2型(Th2)细胞因子表达及预测价值。方法选取2021年1月至2022年9月南昌市第九医院肝病科收治的50例慢性HCV感染患者作为研究对象,按照疾病不同阶段分为慢性丙型肝炎(CHC)组28例、丙型肝炎肝硬化(LC)组12例、丙型肝炎肝癌(HCC)组10例,以50名正常健康人为对照(NC)组,比较50例慢性HCV感染患者与50名正常健康人外周血γ干扰素(IFN-γ)、肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)水平,比较慢性HCV感染患者HCV RNA、丙氨酸转氨酶(ALT)水平。结果HCV感染者中,HCC组患者年龄大于LC组,LC组患者年龄大于CHC组,差异有统计学意义(P<0.05);HCC组患者HCV RNA载量低于LC组,LC组患者HCV RNA载量低于CHC组,差异有统计学意义(P<0.05);CHC、LC、HCC组性别、ALT比较,差异无统计学意义(P>0.05)。各组间IFN-γ、IL-6、IFN-γ/IL-6水平比较,差异有统计学意义(H=12.801、41.346、12.671,P<0.05)。经两两比较可知,CHC、LC、HCC组IFN-γ、lL-6水平均高于NC组,CHC、LC、HCC组IFN-γ/lL-6水平均低于NC组,差异有统计学意义(P<0.05);LC组的IFN-γ高于CHC组和HCC组,差异有统计学意义(P<0.05);HCC组的IL-6水平高于CHC组和LC组,差异有统计学意义(P<0.05);HCC组的IFN-γ/IL-6比值低于LC组和CHC组,差异有统计学意义(P<0.05)。各组间TNF-α、IL-4比较,差异无统计学意义(P>0.05)。慢性HCV感染患者血清中IL-6水平与HCV RNA载量、ALT水平呈不同程度的负相关(r=-0.369、-0.308,P<0.05),差异有统计学意义。IFN-γ水平与HCV RNA载量、ALT水平无明显相关性(r=-0.099、-0.035,P>0.05),差异无统计学意义(P>0.05)。结论感染HCV患者体内细胞免疫功能中,Th2型细胞处在优势的地位。IFN-γ水平在LC组明显升高,IL-6水平在HCC组显著升高,IL-6可能与HCV感染相关性更大,提示了丙型肝炎研究的方向。

Objective To investigate the expression and predictive value of serum T-helper type 1(Th1)/T-helper type 2(Th2)cytokines in different stages of hepatitis C virus(HCV)infection.Methods Fifty chronic HCV infected patients admitted to the Department of Hepatology of the Ninth Hospital of Nanchang from January 2021 to September 2022 were selected as the research objects.They were divided into chronic hepatitis C(CHC)group(28 cases),liver hepatitis C cirrhosis(LC)group(12 cases)and hepatitis C hepatocellular carcinoma(HCC)group(10 cases).Fifty healthy people were divided into normal control(NC)group.The peripheral blood interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),interleukin-4(IL-4)and interleukin-6(IL-6)were compared between fifty chronic HCV infected patients and fifty healthy people.The levels of HCV RNA and alanine aminotransferase(ALT)in chronic HCV infected patients were compared.Results Among patients infected with HCV,the age of HCC group was higher than that of LC group,the age of LC group was higher than that of CHC group,the differences were statistically significant(P<0.05).HCV RNA in HCC group was lower than that of LC group,HCV RNA in LC group was lower than that of CHC group,the differences were statistically significant(P<0.05).There were no significant differences in gender and ALT in CHC,LC and HCC group(P>0.05).The levels of IFN-γ,IL-6 and IFN-γ/IL-6 were significantly significant correlation among IFN-γ,HCV RNA and ALT(r=-0.099,-0.035,P>0.05),and the differences were not statistically significant(P>0.05).Conclusion Th2 cells play a dominant role in the cellular immune function of HCV infected patients.The level of IFN-γincreased significantly in the LC group,and the level of IL-6 increased significantly in the HCC group.IL-6 may be more closely related to HCV infection,suggesting the direction of hepatitis C research.