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[目的]探讨HLADR基因型、血清IFN-γ和TNF-α水平等宿主因素在慢性乙型肝炎病毒(HBV)感染结局的影响。[方法]在青岛市传染病医院2007年6月至2008年12月住院的汉族慢性HBV感染者中,选择159例,包括慢性乙型肝炎(CHB)患者87例,肝硬变(LC)38例,肝细胞癌(HCC)34例,检测HLA-DR等位基因、血清IFN-γ和TNF-α水平。[结果]HLADR13基因频率,CHB组、LC组、HCC组分别为0.00%、7.89%、8.82%(P<0.01),血清IFN-γ水平分别为4.95ng/ml、4.492ng/ml、4.883ng/ml(P>0.05),血清TNF-α水平分别为38.57ng/ml、59.18ng/ml、53.71ng/ml(P<0.01)。多因素非条件Logistic回归分析结果,血清TNF-α水平为发生肝硬变、肝细胞癌的危险因素(OR=2.875)。[结论]慢性HBV感染者血清TNF-α升高是发生肝硬变或肝细胞癌的危险因素。
[Objective] To investigate the effect of host factors such as HLADR genotype, serum IFN-γ and TNF-α levels on the outcome of chronic hepatitis B virus (HBV) infection. [Methods] Among Han patients with chronic HBV infection hospitalized in Qingdao Infectious Disease Hospital from June 2007 to December 2008, 159 patients were selected, including 87 with chronic hepatitis B (CHB), cirrhosis (LC) 38 Cases, hepatocellular carcinoma (HCC) 34 cases, detection of HLA-DR allele, serum levels of IFN-γ and TNF-α. [Results] The frequencies of HLADR13 gene in CHB group, LC group and HCC group were 0.009%, 7.89% and 8.82% respectively (P <0.01). The serum levels of IFN-γ were 4.95ng / ml, 4.492ng / / ml (P> 0.05), serum TNF-a levels were 38.57ng / ml, 59.18ng / ml, 53.71ng / ml (P <0.01). Multivariate non-conditional logistic regression analysis showed that serum TNF-α level was the risk factor of cirrhosis and hepatocellular carcinoma (OR = 2.875). [Conclusion] The increase of serum TNF-α in patients with chronic HBV infection is the risk factor of cirrhosis or hepatocellular carcinoma.