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目的:研究慢性丙型肝炎患者治疗前后血清中白介素-18(IL-18)、干扰素-γ(IFN-γ)及白介素-4(IL-4)的表达情况,探讨IL-18、IFN-γ在及IL-4在慢性丙型肝炎发病中的作用及可能临床意义。方法:酶联免疫吸附法(ELISA)检测20例正常人,42例慢性丙型肝炎患者治疗前后血清中IL-18、IFN-γ在及IL-4水平。结果慢性丙型肝炎患者血清IL-18表达高于健康对照组(380.3±27.2pg/mlvs104.1±10.9pg/ml,P<0.05),血清IFN-γ表达也高于健康对照组(3.2±0.4IU/mlvs1.2±0.2IU/ml,P<0.05),而慢性丙型肝炎患者与健康对照组间IL-4表达无统计学差异(23.8±2.7pg/mlvs23.5±2.9pg/ml,P>0.05)。慢性丙型肝炎患者血清IL-18表达与谷丙转氨酶具有正相关性(r1=0.701,P<0.05);IFN-γ表达与谷丙转氨酶均具有正相关性(r2=0.629,P<0.05)。治疗前慢性丙型肝炎患者应对组血清中IL-18及IFN-γ表达高于无应答组(380.3±27.2pg/mlvs280.1±19.8pg/ml,P<0.05)(3.7±0.4IU/mlvs2.9±0.2IU/ml,P<0.05)。治疗后慢性丙型肝炎患者应答组血清中IL-18及IFN-γ表达较治疗前下调(380.3±27.2pg/mlvs150.6±11.4pg/ml,P<0.05)(3.7±0.4IU/mlvs1.8±0.1IU/ml,P<0.05),治疗后无应答组血清中IL-18及IFN-γ表达较治疗前无统计学差异(280.1±19.8pg/mlvs250.6±24.7pg/ml,P>0.05)(2.9±0.2IU/mlvs2.6±0.5IU/ml,P>0.05),而有无应答组间IL-4在治疗前后均无统计学差异(P>0.05)。结论:慢性丙型肝炎患者中,IL-18及IFN-γ表达增高,IL-4差异无统计学意义,且IL-18及IFN-γ表达与谷丙转氨酶水平有关。IL-18及IFN-γ可能在慢性丙型肝炎的发生发展、预测干扰素联合利巴韦林抗病毒疗效中有一定临床指导意义。
Objective: To investigate the expression of interleukin-18 (IL-18), interferon-γ (IFN-γ) and interleukin-4 (IL-4) in patients with chronic hepatitis C before and after treatment, γ and IL-4 in the pathogenesis of chronic hepatitis C and its possible clinical significance. Methods: Serum levels of IL-18, IFN-γ and IL-4 in 20 normal subjects and 42 chronic hepatitis C patients before and after treatment were detected by enzyme linked immunosorbent assay (ELISA). Results The serum level of IL-18 in patients with chronic hepatitis C was significantly higher than that in healthy controls (380.3 ± 27.2 pg / ml vs 104.1 ± 10.9 pg / ml, P <0.05) 0.4 IU / ml vs 1.2 ± 0.2 IU / ml, P <0.05), while there was no significant difference in IL-4 expression between chronic hepatitis C patients and healthy controls (23.8 ± 2.7 pg / ml vs 23.5 ± 2.9 pg / ml , P> 0.05). The serum level of IL-18 in patients with chronic hepatitis C was positively correlated with alanine aminotransferase (r1 = 0.701, P <0.05). There was a positive correlation between the expression of IFN-γ and alanine aminotransferase (r2 = 0.629, . The levels of IL-18 and IFN-γ in serum of patients with chronic hepatitis C before treatment were higher than those of non-responders (380.3 ± 27.2 pg / ml vs 280.1 ± 19.8 pg / ml, P <0.05) (3.7 ± 0.4IU / ml vs2 .9 ± 0.2 IU / ml, P <0.05). After treatment, the expression of IL-18 and IFN-γ in serum of patients with chronic hepatitis C were significantly lower than that before treatment (380.3 ± 27.2pg / ml vs 150.6 ± 11.4pg / ml, P <0.05) (3.7 ± 0.4IU / mlvs1. 8 ± 0.1IU / ml, P <0.05). There was no significant difference in serum IL-18 and IFN-γlevel between the two groups after treatment (280.1 ± 19.8pg / ml vs 250.6 ± 24.7pg / ml, P > 0.05) (2.9 ± 0.2IU / ml vs2.6 ± 0.5IU / ml, P> 0.05). There was no significant difference in IL-4 between before and after treatment (P> 0.05). Conclusion: The expression of IL-18 and IFN-γ in patients with chronic hepatitis C were increased, while there was no significant difference in IL-4 between them. The expression of IL-18 and IFN-γ was related to the level of alanine aminotransferase. IL-18 and IFN-γ may play an important role in the development of chronic hepatitis C and predict the efficacy of interferon combined with ribavirin antiviral therapy.