乙型肝炎患者外周血白细胞膜γ干扰素受体1的变化及其临床意义

目的研究不同临床类型慢性乙型肝炎患者外周血白细胞膜γ干扰素受体1(IFN-γR1)反应的差异性及其临床意义。方法采用流式细胞技术及夹心酶联免疫吸附法检测53例慢性乙型肝炎患者外周血细胞膜IFN-γR1表达及血清IFN-γ水平变化,并与血生物化学指标、肝组织病理变化进行相关性分析。结果慢性重型肝炎淋巴细胞膜IFN-γR1表达水平显著高于正常对照(28.89％±11.77％)与(9.23％±1.30％)],两者差异有显著性(Z=3.988,P<0.05)。各组间单核细胞膜IFN-γR1表达水平变化差异无显著性。肝硬化、重型肝炎两者血清IFN-γ水平较正常对照,差异有显著性升高,肝硬化、重型肝炎IFN-γ水平组内差异较大,组间无差异。慢性乙型肝炎患者淋巴细胞膜IFN-γR1与总胆红素显著相关(r=0.575,P<0.01),与肝组织炎症活动度显著相关(r=0.621,P<0.01)。结论慢性乙型肝炎淋巴细胞通过上调膜IFN-γR1参与免疫病理。

Modulation and implications in pathogenesis of interferon gamma receptor 1 in patients with chronic hepatitis B

Objective To study the possible differences in the interferon gamma receptor (IFN-y R1) response among a variety of clinical types in patients with chronic hepatitis B (CHB) and implications in pathogenesis. Methods The serum level of IFN-y and the expression level of IFN-y Rl in peripheral leucocytes, from 53 CHB patients, were examined by ELISA and flow cytometry respectively, which were compared with the baseline levels of 15 healthy controls and were performed correlation analysis with alanine aminotransferase (ALT), total bilirubin (TBil) in serum and morphological change in hepatic tissues. Results The results showed that the level of IFN-y Rl (28.89% ?11.77%) expressed on the membranes of lymphocytes in CHB patients, which correlated with liver inflammation (r=0.621, P<0.0\) and serum TBil level (r=0.575, P<0.01), was much higher than that (9.23% + 1.30%) of the healthy controls (Z=3.988, P<0.05), and no obvious difference on the membranes of leucocytes. The serum levels of IFN-y in patients with cirrhosis and severe hepatitis were higher than those of healthy controls . And the two was no difference from each other, but the standard deviation in each group was relatively large. Conclusions These findings suggest that the IFN-y signal transduction pathway is modulated through up-regulating the expression of IFN-y Rl on the membranes of lymphoctes, which takes part in the immuno-pathogenesis in CHB patients.