摘要
目的观察拉米夫定治疗慢性乙型肝炎患者血清IFN-7和IL-4水平的动态变化。方法ELISA法分别检测66例慢性乙型肝炎患者在拉米夫定治疗前，治疗后第3、6、9、12个月时的血清IFN-7和IL-4水平。选取20名健康献血员作为健康对照。治疗前后比较用t检验，计数资料采用非参数秩和检验。结果HBeAg阳性患者拉米夫定治疗前，完全应答组IFN-γ水平为（21．03±4．44）ng／L，明显高于部分应答组的（13．85±3．92）ng／L及无应答组的（10．63±3．11）ng／L（t=7．56，t=11．87，均P〈0．01）；以IFN-7为15.66ng／L为界，治疗前IFN-γ高水平患者完全应答率明显高于低水平患者（31．0％比8．7％，χ^2=8．391，P〈0．01），无应答率明显低于低水平患者（13．8％比52．2％，）χ^2=4．256，P〈0．01）。治疗后完全应答组患者IFN-γ／IL-4接近或高于对照组，部分应答组和无应答组低于对照组；HBeAg阴性患者拉米夫定治疗后IFN-γ／IL-4缓慢上升，但未达对照组水平。结论拉米夫定治疗慢性乙型肝炎可增加IFN-γ释放，抑制IL-4释放，治疗应答程度与治疗后辅助性T淋巴细胞（Th）1／Th2平衡的恢复及治疗前IFN-γ水平有关。
Objective To investigate the effect of lamivudine （LAM） on serum interferon （IFN）-γ and interleukin （IL）-4 levels in patients with chronic hepatitis B（CHB）. Methods Serum IFN-γ and IL-4 levels were measured with enzyme-linked immunosorbent assay （ELISA） in 66 CHB patients at baseline and 3, 6, 9 and 12 months after LAM treatment respectively. And 20 healthy volunteers served as healthy control. The comparision of pretreatment and post-treatment was done using t test and numberation data were analyzed by non parametric rank sum test. Results In HBeAg positive patients, the serum level of IFN-γ was （21.03±4.44） ng/L in complete response group, which was higher than partial response group [-（13. 85±3.92） ng/L] and non-response group [（10. 63±3.11） ng/L] （t=7. 56,t=11. 87, both P〈0. 01）. Take that IFN-γ is 15. 66 ng/L as boundry patients with high baseline IFN-γ level showed much higher complete response rate （31.0% vs 8.7%）χ^2=8.391, P〈0.01） and lower non-response rate （13.8% vs 52.2%,χ^2=4. 256, P〈0.01） than those with low baseline IFN-γ levels. After LAM treatment, the IFN-γ/IL-4 ratios in complete response patients were approximate or even higher than those in healthy group, whereas the IFN-γ/IL-4 ratios of patients with partial response and non-response were lower than those in healthy group. In HBeAg negative patients, the IFN-γ/IL-4 ratios increased slowly but didn＇t reach the same levels of healthy group. Conclusions It is suggested that LAM treatment can increase IFN-γ release and reduce IL-4 release in CHB patients. The response type to LAM therapy is associated with the recovery of T helper cell （Th）1/Th2 balance post-treatment and pretreatment IFN-γ levels.
出处
《中华传染病杂志》
CAS
CSCD
北大核心
2009年第1期27-30,共4页
Chinese Journal of Infectious Diseases
基金
河北省科技厅资助项目（07276101D-34）
