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目的 探讨血清细胞因子水平与乙型肝炎病变的关系。方法 运用ELISA法、比色法及荧光定量PCR技术检测不同类型乙型肝炎患者血清细胞因子、ALT、TBil及IBV -DNA水平 ,观察患者治疗前后细胞因子变化及其与预后的关系。结果 除隐匿性肝炎外 ,急性、慢性及重型肝炎患者血清TNF -α、IL - 6、IL- 8、IL - 12、IL - 18的水平均显著高于对照组 (P <0 .0 0 1) ,升高程度与病情相关 ;急性、慢性肝炎经治疗后 ,细胞因子浓度均明显下降 (P <0 .0 0 5～ 0 .0 0 1) ,重型肝炎患者无明显变化 (P <0 .0 5 ) ;预后好的患者细胞因子水平下降更为明显 (P <0 .0 5 ) ;相关分析表明 :乙肝患者各细胞因子与血清ALT、TBil水平相关 ,与HBV -DNA无相关性。结论 血中细胞因子水平是判断乙肝患者免疫状态、肝脏损伤及评估预后的重要指标。
Objective To investigate the relationship between serum cytokines and the pathological changes of hepatitis B Methods Serum levels of cytokines, ALT, TBil and IBV-DNA in patients with different types of hepatitis B were detected by ELISA, colorimetric and real-time fluorescence quantitative PCR. The changes of cytokines and their relationship with prognosis were observed before and after treatment. Results In addition to occult hepatitis, the levels of serum TNF - α, IL - 6, IL - 8, IL - 12 and IL - 18 in patients with acute, chronic and severe hepatitis were significantly higher than those in the control group ), And the degree of increase was related to the condition. After treatment of acute and chronic hepatitis, the concentrations of cytokines were significantly decreased (P <0.05-0.0.01), but there was no significant change in patients with severe hepatitis (P <0.05). (P <0.05). The correlation analysis showed that the cytokines in patients with hepatitis B were correlated with the levels of serum ALT and TBil, but not with HBV-DNA. Conclusion The level of blood cytokines is an important index to judge the immune status of hepatitis B patients, liver damage and prognosis.