摘要
目的 探讨聚乙二醇干扰素-α(PEG-IFN-α)对慢性乙型肝炎(CHB)患者乙型肝炎表面抗原(HBsAg)及滤泡辅助性T细胞(Tfh细胞)、B细胞标志物水平的影响。方法 选取2017年1月至2018年5月该院收治的84例CHB患者,均采用PEG-IFN-α治疗48周,按免疫应答情况分为完全应答组(28例)、部分应答组(15例)、无应答组(41例),比较治疗后各组肝功能指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、血清总胆红素(STB)]、HBV-DNA、HBsAg水平,以及乙型肝炎病毒e抗原(HBeAg)阳性率、Tfh细胞标志物[肿瘤坏死因子相关激活蛋白(CD40L)、诱导性共刺激分子(ICOS)、标志物程序性死亡分子-1(PD-1)]、B细胞标志物(IgG~+CD21~+、CD38CD138~+)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)、炎症因子γ-干扰素(IFN-γ)、白细胞介素-4(IL-4)、肿瘤坏死因子-α(TNF-α)水平。结果 治疗后完全应答组血清AST、ALT、STB、HBV-DNA、HBsAg水平及HBeAg阳性率低于无应答组、部分应答组,差异有统计学意义(P<0.05);完全应答组患者Tfh细胞标志物CD40L、PD-1表达水平高于无应答组、部分应答组,差异有统计学意义(P<0.05),各组ICOS表达水平差异无统计学意义(P>0.05);完全应答组B细胞标志物IgG~+CD21~+、CD38CD138~+表达水平高于部分应答组、无应答组,IgG、IgM水平明显高于部分应答组、无应答组,差异有统计学意义(P<0.05),各组IgA水平差异无统计学意义(P>0.05);完全应答组IFN-γ水平高于无应答组、部分应答组,IL-4水平低于部分应答组、无应答组,差异有统计学意义(P<0.05),各组治疗前后TNF-α水平比较差异无统计学意义(P>0.05)。结论 PEG-IFN-α治疗CHB患者能有效降低HBsAg水平,提高Tfh细胞及B细胞标志物表达水平。
Objective To investigate the effect of pegylated interferon-α(PEG-IFN-α) on the levels of hepatitis B virus surface antigen(HBsAg),follicular helper T cells(Tfh) and B cell markers in the patients with chronic hepatitis B(CHB).Methods A total of 84 patients with CHB treated in this hospital from January 2017 to May 2018 were selected and treated with PEG-IFN-α for 48 weeks, and divided into the complete response group(28 cases),the partial response group(15 cases) and non-responsive group(41 cases) according to the immune response.The levels of liver function indicators(ALT,AST,STB),HBV-DNA,HBsAg level, HBeAg positive rate, Tfh markers [tumor necrosis factor-related activator protein(CD40 L),inducible costimulatory molecule(ICOS),marker programmed death-1 molecule(PD-1)],B cell markers(IgGCD21,CD38CD138),immunoglobulin A(IgA),immunoglobulin M(IgM),immunoglobulin G(IgG) and inflammatory factors γ-interferon(IFN-γ),interleukin-4(IL-4) and tumor necrosis factor-α(TNF-α) after treatment were compared among the groups.Results After treatment, the levels of serum AST,ALT,STB,HBV-DNA and HBsAg, and HBeAg positive rate in the complete response group were lower than those in the non-response group and partial response group, and the differences were statistically significant(P<0.05).The expression levels of CD40 L and PD-1 on the Tfh cell of the patients in the complete response group were higher than those in the non-response group and partial response group, and the differences were statistically significant(P<0.05),and the ICOS expression level had no statistically significant difference among the various groups(P<0.05).The expression levels of IgGCD21and CD38CD138on the B cell in the complete response group were higher than those in the partial response group and the non-response group, and the differences were statistically significant(P<0.05),while the levels of IgG and IgM were significantly higher than those in the partial response group and non-response group, and the differences were statistically significant(P<0.05).There was no statistically significant difference in the IgA level among the various groups(P>0.05).The level of IFN-γ in the complete response group was higher than that in the non-response group and the partial response group, and the IL-4 level was lower than that in the partial response group and the non-response group, and the differences were statistically significant(P<0.05).There was no statistically significant difference in TNF-α level in each group between before and after treatment(P>0.05).Conclusion PEG-IFN-α in treating the patients with CHB can effectively reduce the HBsAg level, increase the expression levels of Tfh cell and Bcell markers.
作者
屈虹霞
董建毅
史莉华
QU Hongxia;DONG Jianyi;SHI Lihua(Endoscope Room,West Station Aera of First Hospital of Lanzhou University,Lanzhou,Gansu 730050,China)
出处
《国际检验医学杂志》
CAS
2022年第18期2288-2291,2297,共5页
International Journal of Laboratory Medicine
