慢性乙型肝炎不同临床分型患者IL-12水平及Th1/Th2细胞平衡的相关性研究

目的探究慢性乙型肝炎(Chronic hepatitis B,CHB)不同临床分型患者IL-12水平与Th1/Th2细胞平衡的相关性。方法选择2018年1月-2019年4月广元市第一人民医院感染科收治的慢性乙型肝炎患者70例。根据临床分型的不同,分为轻度32例(CHBⅠ级组)、中度29例(CHBⅡ级组)和重度9例(CHBⅢ级组),选择同期体检健康者30名作为对照组。采用RT-PCR法检测血清乙型肝炎病毒(HBV)DNA含量;ELISA检测血清白细胞介素-12(Interleukin-12、IL-12)水平和HBV标志物乙肝e抗原(HBeAg)、乙肝表面抗原(HBsAg)、乙肝e抗体(抗-HBe)]水平;检测外周血Th1、Th2及Th1/Th2细胞比例。结果 CHBⅠ级组患者血清HBV DNA病毒载量显著低于CHBⅡ级组和CHBⅢ级组(P<0.05);CHBⅠ级组HBeAg、HBsAg水平显著低于CHBⅡ级组和CHBⅢ级组,而抗-HBe水平显著高于CHBⅡ级组和CHBⅢ级组(P<0.05);CHB患者血清IL-12水平显著高于对照组(P<0.05),且随着CHB患者病情的加重,血清IL-12水平显著升高(P<0.05);CHB患者的Th2细胞比例显著高于对照组,而Th1、Th1/Th2显著低于对照组(P<0.05),随着CHB患者病情的加重,Th2细胞比例显著升高,而Th1、Th1/Th2显著降低(P<0.05)。结论慢性乙型肝炎患者体内存在Th1/Th2失衡现象,患者病情严重程度与体内HBV DNA载量呈正比,病毒复制水平升高可能与Th1细胞减少,机体的病毒清除能力下降,特异性细胞免疫应答减弱有关。

Correlation between IL-12 level and Th1/Th2 cell balance of patients with different clinical types of chronic hepatitis B

OBJECTIVE To explore the correlation between the IL-12 level and the Th1/Th2 cell balance of patients with different clinical types of chronic hepatitis B(CHB).METHODS A total of 70 patients with CHB who were treated in Guangyuan First People′s Hospital from Jan 2018 to Apr 2019 were enrolled in the study and divided into the CHB I group with 32 mild cases,the CHBⅡgroup with 29 moderate cases and the CHBⅢgroup with 9 severe cases according to the clinical classification,meanwhile,30 healthy people who received physical examination were set as the control group.The serum hepatitis B virus(HBV)DNA load was determined by using RT-PCR,the levels of serum interleukin-12(IL-12)and HBV markershepatitis B e Antigen(HBeAg),hepatitis B surface Antigen(HBsAg),hepatitis B e Antibody(anti-HBe)]were detected by using ELISA,and the percentages of peripheral blood Th1 and Th2 as well as Th1/Th2 were detected.RESULTS The serum HBV DNA load of the CHBⅠgroup was significantly lower than that of the CHBⅡgroup and the CHBⅢgroup(P<0.05).The levels of HBeAg and HBsAg of the CHBⅠgroup were significantly lower than those of the CHBⅡgroup and the CHBⅢgroup,while the anti-HBe level of the CHBⅠgroup was significantly higher than that of the CHBⅡgroup and the CHBⅢgroup(P<0.05).The serum IL-12 level of the patients with CHB was significantly higher than that of the study objects in the control group(P<0.05),and the serum IL-12 level was significantly elevated with the exacerbation of illness condition of the CHB patients(P<0.05).The percentage of Th2 cell of the CHB patients was significantly higher than that of the study objects in the control group,while the percentage of Th1 cell and Th1/Th2 were significantly lower in the CHB patients than in the study objects in the control group;with the exacerbation of illness condition,the percentage of Th2 cell of the CHB patients was significantly elevated,while the percentage of Th1 cell and Th1/Th2 were significantly reduced(P<0.05).CONCLUSION There is a Th1/Th2 imbalance in the patients with CHB,the severity of the disease is directly proportional to the HBV DNA load in the body.The increase of viral replication may be associated with the decline of the percentage of Th1 cell,reduction of the viral removal capability of the body and decrease of immune response of specific cells.