慢性重型乙型肝炎患者血清趋化因子RANTES与MIG水平检测及其意义

目的：了解慢性重型乙型肝炎（简称慢重肝）患者血清趋化因子调节激活正常T细胞表达的分泌的细胞因子（RANTES）、γ-干扰素诱生的单核因子（MIG）水平,并探讨患者血清RANTES、MIG水平与丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、总胆红素（TBil）、凝血酶原活动度（PTA）及乙型肝炎病毒脱氧核糖核酸（HBVDNA）载量的相关性。方法：运用双抗体夹心酶联免疫吸附法检测23例慢重肝患者（肝炎组）和14名健康人（正常对照组）血清中趋化因子RANTES、MIG的浓度,并与患者的肝功能生化指标、HBV DNA载量进行相关性分析,利用SPSS 11.5软件进行统计分析。结果：慢重肝患者血清RANTES浓度[（288.52±54.96）ng/ml]低于正常对照组[（456.77±20.34）ng/ml],其差异有显著性意义（P〈0.05）;慢重肝患者血清MIG浓度[（91.49±18.71）ng/ml]高于正常对照组[（11.43±1.44）ng/ml],其差异有显著性意义（P〈0.05）;MIG水平与AST、ALT呈正相关,与TBil、PTA、HBV DNA无明显相关。结论：慢性重型乙型肝炎患者血清RANTES水平降低,MIG水平增高;RANTES水平不能反映肝细胞坏死程度,MIG参与肝脏炎性细胞浸润,介导肝组织损伤,可能参与重型肝炎发病机制。

Correlation of serum chemokine RANTES and MIG in patients with fulminant hepatitis B

Objective：To investigate the relationship of the serum chemokine RANTES and MIG with serum biochemical indices of liver function,prothrombin activity（PTA） and HBV DNA load in patients with fulminant hepatitis B.Methods：Serum RANTES and MIG levels were determined by ELISA method in 26 fulminant hepatitis cases and 14 healthy people.Statistical analysis was performed on the software of SPSS 11.5.Results：The serum chemokine RANTES level in the hepatitis group [（288.52±54.96） ng/ml] was less than that in the control group [（456.77±20.34） ng/ml].The serum chemokine MIG level in the hepatitis group[（91.49±18.71）ng/ml] was significant higher than that in the control group [（11.43±1.44） ng/ml].The results from the hepatitis group indicated the positive correlation of serum MIG level with indices of serum alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,but not with total bilirubin（TBil）,PTA and HBV DNA.Conclusion：Serum chemokine MIG level in patients with fulminant hepatitis B elevated significantly,but serum chemokine RANTES level was less in patients with fulminant hepatitis.The correlation with indices of liver fuction test indicated that chemokine might play an important role in migration of the inflammatory cells to the liver and mediate the development of fulminant hepatitis B.