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目的探讨血清IL-10、IL-13、IL-15水平在乙型肝炎发生发展中的意义。方法采用双抗体夹心ELISA法检测2002年5月至2004年9月泉州市第一医院感染科109例乙型肝炎患者血清中IL-10、IL-13、IL-15水平。结果慢性肝炎中度患者血清IL-10、IL-13显著高于慢性重型肝炎、慢性肝炎重度、急性肝炎及正常对照组(P<0.01)。IL-15值比较,急性肝炎、慢性肝炎中度、慢性肝炎重度、慢性重型肝炎明显高于正常对照组(P<0.01)。IL-15/IL-10、IL-15/IL-13比值,慢性重型肝炎、慢性肝炎重度、急性肝炎明显高于慢性肝炎中度及正常对照组(P均<0.01)。慢性重型肝炎死亡组IL-15值及IL-15/IL-10、IL-15/IL-13比值明显高于治疗好转组(P<0.01)。结论乙型肝炎患者存在异常的细胞免疫应答,通过联合检测血清IL-10、IL-13、IL-15值及IL-15/IL-10、IL-15/IL-13比值,能较好地反映乙型肝炎患者Th1/Th2细胞激活状态,有助于不同临床类型的乙型肝炎患者的预后判断及指导治疗。
Objective To investigate the significance of serum IL-10, IL-13 and IL-15 levels in the development of hepatitis B. Methods Serum levels of IL-10, IL-13 and IL-15 in 109 patients with hepatitis B from January 2002 to September 2004 in Quanzhou First Hospital were detected by double antibody sandwich ELISA. Results Serum levels of IL-10 and IL-13 in patients with chronic hepatitis were significantly higher than those in patients with chronic severe hepatitis, chronic hepatitis, acute hepatitis and normal controls (P <0.01). IL-15 values, acute hepatitis, chronic hepatitis, moderate, chronic severe hepatitis, chronic severe hepatitis were significantly higher than the normal control group (P <0.01). The ratios of IL-15 / IL-10, IL-15 / IL-13, chronic severe hepatitis, chronic severe hepatitis and acute hepatitis were significantly higher than those in moderate and chronic chronic hepatitis group (all P <0.01). The ratio of IL-15, IL-15 / IL-10 and IL-15 / IL-13 in the death of chronic severe hepatitis was significantly higher than that in the treatment-remission group (P <0.01). Conclusions Abnormal cellular immune response exists in patients with hepatitis B, and the serum IL-10, IL-13 and IL-15 levels and the ratios of IL-15 / IL-10 and IL- 15 / IL- Reflect the activation of Th1 / Th2 cells in patients with hepatitis B, contribute to the prognosis of different clinical types of hepatitis B patients and guide the treatment.