干扰素α-2b对慢性乙型肝炎患者血清干扰素诱导蛋白、活性调节蛋白水平的影响

目的 观察慢性乙型肝炎患者血清干扰素诱导蛋白(IP-10)和正常T细胞表达分泌的活性调节蛋白(RANTES)在干扰素α-2b治疗前、后的变化.方法 选择50例HBeAg阳性慢性乙型肝炎患者予以普通干扰素α-2b治疗,根据治疗12周时病毒学应答情况分为完全应答A组(32例)、部分应答B组(12例)、无应答C组(6例).Luminex液相蛋白芯片法检测三组治疗前及治疗后4周、12周血清IP-10、RANTES水平,并同时检测血清HBV DNA水平、ALT水平和HBV标志物.结果 治疗前,三组间血清HBV DNA、RANTES水平差异无统计学意义(P＞0.05)；三组间ALT水平差异均有统计学意义(P＜0.05)；三组IP-10、RANTES水平均较正常对照组升高(P＜0.05);三组间IP-10水平差异有统计学意义(P＜0.05),其中A组最高(24.05±7.68),B组次之(20.85:±:4.85),C组最低(11.25±5.65);与治疗前相比,治疗4周A组血清IP-10、RANTES水平开始下降(P＜0.05),B组、C组无明显差别(P＞0.05)；治疗12周时,三组IP-10水平变化差异有统计学意义(- 17.28±4.25、-8.34±1.10、+1.68±0.22)(P＜0.05),RANTES水平变化差异有统计学意义(- 38.57±3.54、- 13.87 ±3.14、-6.65±1.79)(P＜0.05)；C组的IP-10、RANTES水平在治疗4、12周时均无统计学意义(P＞0.05)；治疗12周时,三组HBV DNA水平变化差异有统计学意义(3.91±1.13、2.62±0.52、0.98±0.80)(P＜0.05);三组ALT水平变化差异有统计学意义(- 157.2±26.8、-39.2±11.4、+3.7±8.9)(P＜0.05)；50例患者血清IP-10水平与ALT水平呈正相关,RANTES水平与HBV DNA水平呈正相关,治疗前IP-10水平与治疗12周时的HBV DNA下降水平呈正相关；应答组44例治疗12周的IP-10、RANTES下降水平与ALT下降水平呈正相关.结论 干扰素α-2b治疗后慢性乙型肝炎患者肝脏炎症减轻,与IP-10、RANTES水平下降有关.

Relationship between the serum chemokine IP-10 and RANTES levels and Interferon therapeutic early response in patients with chronic hepatitis B

Objective To investigate the relationship between the serum chemokine IP-10 and RANTES lev- els and Interferon therapeutic early response in patients with chronic hepatitis B （CHB）. Methods 50 patients with chronic hepatitis B were chosen into interferon therapy. After 12 weeks,they were devided into three groups：complete response A,partial response B,non response C group. HBV-DNA was detected by PCR; The serum chemokines（ IP-10 and RANTES） were measured by Luminex Liquichip technology. Results The base HBV DNA and RANTES levels of three groups weren＇t significantly different （ P 〈 O. 05 ） ; The base ALT and IP-10 levels of A group were significantly higher than that in B and C group（P 〈 0. 05）. The IP-10,RANTES contents of A group in therapeutic 4th week were significantly lower than that before interferon therapy（P 〈 0. 05） ;There were no significant differences in B,C group （P 〉 0. 05） ;The levels changes of IP-10,RANTES, HBV DNA and ALT in therapeutic 12th week were significantly different between the three groups（ P 〈 0.05 ）. The level of ALT in 50 patients has positive correlation with IP-IO level （P 〈 0.05 ） ;The level of HBV DNA in 50 patients had positive correlation with RANTES level（ P 〈 0.05 ） ;The base level of IP-IO had positive correlation with the change of HBV-DNA contents in therapeutic 12th week （P 〈 0. 05 ） ; The change of ALT level in reponse patients in therapeutic 12th week had positive correlation with the change of IP- 10,RANTES levels （P 〈 0.05 ）. Conclusion The decrease of IP-10, RANTES level in CHB patients received 12 weeks interferon-or therapy could lead to reduce liver inflammation;The base IP-10 level probably was relevant to the early response in CHB patients received interferon-αtherapy.