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目的:探讨检测IL-12、IFN-γ和IL-10对病毒性肝炎患者的临床意义。方法:利用ELISA法检测97例病毒性肝炎患者血清IL-12、IFN-γ和IL-10水平,动态观察45例接受免疫增强剂治疗的慢性肝炎患者上述细胞因子的变化。结果:急性肝炎患者血清IL-12及IFN-γ水平均明显升高(P<0.01);慢性肝炎、肝硬化患者血清中IL-10明显高于正常对照组(P<0.01)。免疫增强剂治疗获得完全应答反应的患者治疗期间血清IL-12、IFN-γ水平明显上升(P<0.01),IL-10水平下降(P<0.05),无应答者治疗过程中上述细胞因子无明显变化。结论:Thl型免疫应答对机体清除病毒起关键作用;Th2型免疫应答与感染慢性化及疾病持续发展有关;免疫治疗可使部分Th2型免疫应答占优势的慢性肝炎患者转化为Th1型占优势。
Objective: To investigate the clinical significance of detecting IL-12, IFN-γ and IL-10 in patients with viral hepatitis. Methods: Serum levels of IL-12, IFN-γ and IL-10 in 97 patients with viral hepatitis were detected by ELISA. The changes of cytokines in 45 patients with chronic hepatitis treated with immune enhancers were observed dynamically. Results: Serum levels of IL-12 and IFN-γ were significantly increased in patients with acute hepatitis (P <0.01). IL-10 in patients with chronic hepatitis and cirrhosis was significantly higher than that in controls (P <0.01). Serum levels of IL-12 and IFN-γ were significantly increased (P <0.01) and IL-10 levels were decreased (P <0.05) in the patients with complete response response to the immunostimulant therapy. The levels of these cytokines obvious change. Conclusion: Th1 type immune response plays a key role in virus clearance. Th2 type immune response is associated with chronic infection and persistent disease development. Immunotherapy can make patients with chronic hepatitis with predominant Th2 immune response predominantly convert to Th1 type.