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目的 探讨慢性乙型肝炎病理过程中细胞因子IL 10、IL 12、IL 18和IFN γ血清水平的变化及其临床意义。方法 2 7例慢性乙型肝炎患者和 2 5例健康人均于清晨空腹采血以双抗夹心ELISA法检测IL 10、IL 12、IL 18和IFN γ水平并同时检测肝功能和乙肝病毒血清学指标。结果 慢性乙型肝炎患者血清IL 10、IL 12、IL 18和IFN γ水平均显著高于对照组 (P <0 .0 1) ,其中慢性乙型肝炎重度患者IL 12、IL 18和IFN γ水平较轻中度患者显著增高 (P值分别 <0 .0 1,<0 .0 1,<0 .0 5 ) ;HBeAg阴性组IL 12和IL 18较HBeAg阳性组明显升高 (P值分别 <0 .0 5和 <0 .0 1) ,而IL 10和IFN γ则无明显变化 ;上述各因子均与血清ALT、T Bil呈显著正相关 (r分别 =0 .5 88、0 .477,0 .5 2 0、0 .612 ,0 .5 45、0 .85 5 ,0 .60 6、0 .864 ) ,IL 12还与HBVDNA量呈显著负相关 (r= -0 .5 1)。结论 慢性乙型肝炎患者存在异常的细胞免疫应答 ,IL 10、IL 12、IL 18和IFN γ均参与了慢性乙型肝炎的病理生理过程 ,并且与肝炎的病情变化密切相关
Objective To investigate the changes of serum IL-10, IL-12, IL-18 and IFN-γ levels in patients with chronic hepatitis B and their clinical significance. Method 2 Seventeen patients with chronic hepatitis B and twenty-five healthy individuals were tested for IL-10, IL-12, IL-18 and IFN-gamma levels by fasting fasting blood samples by double-antibody sandwich ELISA at the same time to detect liver function and HBV serology. Results Serum levels of IL-10, IL-12, IL-18 and IFN-γ in patients with chronic hepatitis B were significantly higher than those in controls (P <0.01). The levels of IL 12, IL 18 and IFN γ in patients with chronic hepatitis B (P <0.01, <0.01, <0.05). The levels of IL 12 and IL 18 in HBeAg-negative group were significantly higher than those in HBeAg-positive group (P < 0.05 and <0.01), while there were no significant changes in IL 10 and IFN γ. All the above factors were positively correlated with serum ALT and T Bil (r = 0.588,0.477, 0 .5 2 0,0 .612, 0 .5 45,0 .85 5,0.60 6,0. 864). IL 12 was also significantly negatively correlated with the amount of HBVDNA (r = -0.51). Conclusion Abnormal cellular immune response exists in patients with chronic hepatitis B, IL 10, IL 12, IL 18 and IFN γ are involved in the pathophysiological process of chronic hepatitis B, and are closely related to the changes of hepatitis