核苷类似物抗病毒治疗对乙型肝炎肝硬化患者血清Th1/Th2型细胞因子水平的影响及临床意义

目的：研究核苷类似物抗病毒治疗对乙型肝炎肝硬化患者血清Th1/Th2（辅助性T淋巴细胞1/辅助性T淋巴细胞2）型细胞因子水平的影响及临床意义。方法：选择乙型肝炎肝硬化患者35例,其中25例接受核苷类似物抗病毒治疗及普通护肝治疗,10例仅接受普通护肝治疗。应用双抗体夹心ELISA法检测血清IL-4（白细胞介素-4）、IL-6、IL-8、IL-18、IFN-γ（γ干扰素）含量;同时检测患者肝功能及HBV DNA。结果：乙型肝炎肝硬化患者核苷类似物抗病毒治疗前后IL-4、IL-6、IL-8、IL-18、IFNγ-、ALT、A lb、TB il、HBV DNA含量之差异有显著性意义（P〈0.05,见表2）,且细胞因子IL-6、IFN-γ水平与HBV DNA水平有相关性（P〈0.05,见表5）。对照组予以普通护肝治疗前后IL-8、ALT、A lb之差异有显著性意义（P〈0.05,见表2）,而IL-4、IL-6、IL-18、IFN-γ、TB il、HBV DNA之差异无显著性意义（P〉0.05,见表2）;核苷类似物抗病毒治疗组不同肝脏贮备功能等及不同的患者之间细胞因子变化的差异无显著性意义（P〉0.05,见表3）,而不同核苷类似物治疗前后IL-4、IL-6、IFN-γ变化差异有显著性意义（P〈0.05,见表4）。结论：核苷类似物在抑制病毒复制的同时,能平衡乙型肝炎肝硬化患者细胞因子网络,调节机体的免疫功能。

Influence and clinical significance of nucleoside analogs antiviral therapy on level of Th1/Th2 cytokines in serum of hepatitis B virus-related cirrhosis

Objective：To study the influence and clinical significance of nucleoside analogs antiviral therapy on the level of Th1/Th2 cytokines in serum of hepatitis B virus-related cirrhosis.Methods： Selecting 35 hepatitis B virus-related cirrhosis,of which 25 cases accepted nucleoside analogs antiviral therapy and ordinary liver protecting treatment,and another 10 only accepted the ordinary liver protecting treatment.Applied double-antibody sandwich ELISA to test the level of serum IL-4,IL-6,IL-8,IL-18,IFN-γ;meanwhile,to detect the liver function and HBV DNA of the patients.Results：For hepatitis B virus-related cirrhosis who accepted the therapy of nucleosied analogs antiviral,a significant difference can be reflected by the level of IL-4,IL-6,IL-8,IL-18,IFN-γ,ALT,Alb,TBil,HBV DNA before and after the therapy of nucleoside analogs antiviral（P〈0.05）,see sheet 2],and relevance can be also seen between the level of cytokines IL-6,IFN-γ and the level of HBV DNA（P〈0.05）,see sheet 5）.Contrast group with the patients who accepted ordinary liver protecting treatment,there was a significant difference（P〈0.05,see sheet 2）;in the level of IL-8,ALT,Alb before and after the treatment,while the level of IL-4,IL-6,IL-18,IFN-γ,TBil,HBV DNA had not significant difference（P〈0.05,see sheet 2）;in the group with nucleoside analogs antiviral therapy,no significant difference can be found in the level of cytokines in different classification of liver function（P〈0.05,see sheet 3）,while there was a significant difference of the level of IL-4,IL-6,IFN-γ before and after the different nucleoside analogs antiviral therapy（P〈0.05,see sheet 4）.Conclusion：Nucleoside analogs not only suppress virus replication,but also balance the cytokine network of hepatitis B virus-related cirrhosis and adjust the immune function of organism.