【摘要】 目的探讨不同HBVDNA载量慢性乙型肝炎(CHB)患者经拉米夫定治疗前后外周血单核细胞(PM-BC)分泌IFN-γ、IL-6水平变化规律及其临床意义。方法血清HBVDNA载量采用荧光定量聚合酶链反应(FQ-PCR)测定,PMBC分泌IL-6、IFN-γ水平采用双抗体夹心酶联免疫吸附试验(DAS-ELISA)测定。结果治疗前CHB患者IFN-γ水平显著低于正常对照组(P<0.01),IL-6水平显著高于正常对照组(P<0.01);拉米夫定治疗后HBV高、中载量组IFN-γ水平较治疗前显著升高(P<0.01和P<0.05),IL-6水平较治疗前显著降低(P<0.01和P<0.05),治疗后中、低载量组IFN-γ水平仍低于正常对照组(P<0.01),IL-6的水平高于正常对照组(P<0.01);患者INFγ水平变化与HBVDNA载量呈负相关(r=0.89,P<0.001),IL-6水平变化与HBVDNA载量和ALT呈正相关(分别为:r=0.92,P<0.001;r=0.74,P<0.001)。结论不同HBVDNA载量CHB患者经拉米夫定治疗应答与IFN-γ、IL-6水平程度有关,IFN-γ和IL-6的含量能较好的反映TH1/TH2的水平,且可以作为CHB疗效参考指标。更多还原

【Abstract】 Objective To investigate the different HBVDNA load in chronic hepatitis B(CHB) patients treated with lami-vudine before and after peripheral blood mononuclear cells(PMBC) secretion of IFN-γ,IL-6 level changes and its clin-ical significance.Methods Fluorescence quantitative polymerase chain reaction(FQ-PCR) was used to detect the quan-tity of HBV load and enzyme-liked immunosorbent assay(ELISA) was used to determine the levels of INFγ and IL-6 se-creted by phytohemagglutinin(PHA) stimulated PBMC.Results IFN-γ level was lower but IL-6 level was higher than that of the control group(P < 0.01) before lamivudine treatment.After lamivudine treatment,IFN-γ levels were signifi-cantly increased(P < 0.01 and P < 0.05 respectively),but IL-6 levels were significantly decreased(P < 0.01 and P < 0.05 respectively) in patients from HBVDNA high and middle level groups.However,in patients from HBVDNA middle and low level group,IFN-γ level was lower but IL-6 level was higher than that of control group(P < 0.01).There was a negative correlation between IFN-γ level and the HBVDNA level(r = 0.89,P < 0.00 1),but IL-6 level positively corre-lated with HBVDNA level(r = 0.92,P < 0.001) and ALT level(r = 0.74,P < 0.001).Conclusion IFN-γ and IL-6 levels secreted by PBMC in CHB patients can be used for the judgment of therapeutic effects during lamivudine treatment.更多还原