摘要
目的通过慢性乙型肝炎(CHB)患者不同临床过程中γ干扰素(IFN-γ)、肿瘤坏死因子α(TNF-α)与丙氨酸转移酶(ALT)和HBV DNA水平相关性研究,探讨IFN-γ和TNF-α对乙型肝炎病毒(HBV)复制影响。方法选取慢性乙型肝炎急性发作患者30例(急性发作组)、慢性乙型肝炎需要抗病毒治疗患者30例(慢性乙型肝炎组)、慢性乙型肝炎免疫耐受患者20例(免疫耐受组),急性发作组和慢性乙型肝炎组接受恩替卡韦或替诺福韦酯治疗。采集基线时血清肝功能、HBV DNA、HBe Ag、抗-HBe、肌酐、肌酸激酶、IFN-γ、TNF-α水平和肝脏超声检查,并在临床观察第12、24周进行随访评估。结果急性发作组基线ALT、天冬氨酸转移酶(AST)、总胆红素(TBil)、TNF-α、IFN-γ水平较高(P <0. 001),免疫耐受组基线HBV DNA水平较高(P <0. 05)。急性发作组ALT、HBV DNA、TNF-α、IFN-γ水平经核苷类似物(NAs)治疗后明显下降(P <0. 05);慢性乙型肝炎组ALT、HBV DNA、TNF-α水平经NAs治疗后明显下降(P <0. 05),IFN-γ水平经NAs治疗后变化差异无统计学意义(P> 0. 05);免疫耐受组ALT、HBV DNA、IFN-γ、TNF-α水平在观察期间变化差异无统计学意义(P>0. 05)。急性发作组TNF-α、IFN-γ水平与ALT水平具有正相关性(P <0. 001),TNF-α、IFN-γ水平与HBV DNA水平具有正相关性(P <0. 001)。结论慢性乙型肝炎急性发作患者TNF-α、IFN-γ与HBV DNA水平具有正相关性,TNF-α、IFN-γ与HBV复制关系密切。
Objective To study the correlation of serum HBV DNA with interferon-γ(IFN-γ)and tumor necrosis factor-α(TNF-α)in Chronic Hepatitis B(CHB) patients and to explore the effect of IFN-γand TNF-α on Hepatitis B virus (HBV) replication. Methods Thirty patients with acute exacerbation of chronic hepatitis B (acute exacerbation group),30 patients with chronic hepatitis B requiring antiviral therapy (CHB group),and 20 patients with chronic hepatitis B immune tolerance (immune tolerance group) were selected.The patients of acute exacerbation group and CHB group were treated with entecavir or tenofovir disoproxil.The liver function,the serum levels of HBVDNA,HBeAg,anti-HBe,creatinine,creatine kinase,IFN-γ,TNF-α,and the ultrasound examination were measured.The patients were followed up and evaluated at 12 and 24 weeks.Bivariatet and Pearson correlation analysis were used for statistical analysis, P <0.05 was considered statistically significant. Results The levels of Alanine aminotransfease(ALT),Aspartate aminotransferase(AST),Total bilirubin(TBil),TNF-α,IFN-γ in the patients of acute exacerbation group were higher than that in CHB and immune tolerant group.( P <0.001).The levels of HBV DNA in the immune tolerant patients were higher than that in CHB group( P <0.05).After treated with NAs,the levels of ALT,HBVDNA,TNF-α,IFN-γ in the patients of acute exacerbation group were reduced significantly( P <0.05). The levels of ALT,HBVDNA TNF-α in the patients of CHB group also decreased( P <0.05),while there were no significant changes in serum IFN-γ.The levels of ALT,AST,TBil,TNF-αand IFN-γ in the immune tolerant patients didn't change significantly.There was positive correlation between TNF-α,IFN-γ and ALT,HBV DNA in patients with acute exacerbation. Conclusion There were positive correlation between TNF-α,IFN-γ and HBV DNA in patients with acute exacerbation of CHB.TNF-α and IFN-γ are closely related to HBV replication.
作者
阮建文
郑琳麟
高丽娟
苏汝开
RUAN Jian-wen;ZHENG Lin-lin;GAO Li-juan(Department of Infectious Diseases,Central Laboratory,Haikou Hospital Affiliated to Xiangya School of Medicine,Central South University,Haikou Hainan 570208,China)
出处
《湖北科技学院学报（医学版）》
2019年第3期216-220,共5页
Journal of Hubei University of Science and Technology(Medical Sciences)
基金
海南省卫生计生行业科研项目(18A200094)
