论文部分内容阅读
目的:检测慢性丙型肝炎患者血清细胞因子IL-2、IFN-г、IL-5、IL-6、IL-12P70和P40水平,探讨其与患者血清ALT水平、HVC RNA载量、HCV基因型及干扰素疗效的关系。方法:检测30例健康对照者和30例慢性丙型肝炎患者干扰素治疗前后血清IL-2、IFN-г、IL-5、IL-6、IL-12P70和P40的含量,比较干扰素治疗应答组和无应答组之间细胞因子水平的差异及上述细胞因子水平与血清ALT水平、HCV基因型、HCVRNA载量等的关系。血清细胞因子检测应用ELISA法,HCV基因分型应用直接测序法,HCVRNA载量采用荧光定量PCR法。结果:与健康对照组相比,慢性丙型肝炎患者血清IL-2含量明显降低,IL-5和IL-12P40明显生高;血清IL-6含量与血清ALT水平呈正相关,与RNA载量呈负相关;HCV基因型1型患者血清IL-6含量明显高于2型,其他基因型和亚型之间细胞因子水平均无显著性差异;干扰素治疗的持续应答率为46.7%,应答组和无应答组治疗前血清细胞因子水平均无显著性差异,但应答组治疗结束时IFN-γ含量较治疗前明显升高。结论:血清Th1/Th2细胞因子水平失衡与丙型肝炎的慢性化和肝脏炎症活动相关;干扰素治疗前血清Th1/Th2细胞因子水平与干扰素治疗效果无关,不能对疗效进行预测,干扰素诱导的Th1细胞优势反应与持续应答有关。
Objective: To detect the levels of serum cytokines IL-2, IL-6, IL-6, IL-12 and P40 in patients with chronic hepatitis C And the effect of interferon. Methods: The levels of IL-2, IFN-γ, IL-5, IL-6, IL-12P70 and P40 were measured before and after treatment with interferon in 30 healthy controls and 30 chronic hepatitis C. The interferon- The difference of cytokines level between the group and the non-responder group and the relationship between the level of cytokines and serum ALT level, HCV genotype, HCV RNA load and so on. Serum cytokine detection using ELISA, HCV genotyping using direct sequencing, HCV RNA load using quantitative PCR. Results: Compared with the healthy control group, serum IL-2 level was significantly lower and IL-5 and IL-12P40 levels were significantly higher in patients with chronic hepatitis C. The level of serum IL-6 was positively correlated with serum ALT level, The serum level of IL-6 in HCV genotype 1 patients was significantly higher than that of genotype 2, and there was no significant difference in cytokine levels between other genotypes and subtypes. The response rate of interferon therapy was 46.7% There was no significant difference in the levels of serum cytokines before treatment in the non-responder group, but the IFN-γ content in the responder group was significantly higher than that before treatment. CONCLUSION: The imbalance of serum Th1 / Th2 cytokines is associated with chronic hepatitis C and inflammatory activity of the liver. The level of Th1 / Th2 cytokines in serum before interferon treatment has nothing to do with the effect of interferon treatment, and the effect of interferon can not be predicted The predominant Th1 cell response is associated with sustained response.