【作者】 吴健林；

【导师】 吴继周； 罗光汉； 江建宁；

【作者基本信息】 广西医科大学 ， 传染病学， 2002， 硕士

【摘要】 目的：探讨细胞因子IL-2、IFN-r、IL-4、IL-10对慢性乙肝患者的病情、乙肝病毒(HBV)复制及HBVDNA BCP变异的影响。 方法：采用PCR微板核酸杂交结合ELISA技术检测HBVDNA BCP变异；PCR结合荧光探针体外DNA扩增技术测定HBVDNA含量；用双抗体夹心ELISA法检测IL-2、IFN-r、IL-4和IL-10水平。 结果：(1)根据研究对象病情及预后不同分组进行统计分析发现：慢性重症肝炎组、肝炎后肝硬化组和慢性肝炎组(包括慢肝轻度和中度)病人的IL-2、IFN-r、IL-4和IL-10水平分别为：(单位：pg／ml)87.8±16.9，265.8±228.2，77.7±95.0，109.8±48.4；58.5±20.5，73.6±52.6，66.9±51.8，77.2±33.7和52.4±20.3，32.3±27.5，50.2±35.3，56.9±34.5，其中，慢性重症肝炎组的IL-2、IFN-r和IL-10水平显著高于肝炎后肝硬化和慢性肝炎组病人的水平(P＜0.05)，而IL-4在各组无明显差别(P＞0.05)；死亡病例组和存活病例组的IL-2、IFN-r、IL-4和IL-10的水平分别为：(pg／ml)91.0±19.9，280.7±243.9，86.8±101.6，70.2±49.6和66.0±19.0，93.9±75.9，61.9±50.6，75.1±31.6。其中，IL-2和IFN-r水平死亡病例明显高于存活患者(P＜0.0F)，IL-4和IL-10 水平在两组之间无明显差异O0．0幻；o）朋WM阮P变异组 禾一变异组的 IL－2，IFN－r，IL－4禾 几－10水平分别为：（pg／ml）61．4 士24．7，128．3士107．1，66．3土56．7，76．7士54．5和 67．l土24．3， 33．1士 98．7，59．4上 43．3，72．5 f 37．2，经统计分析各细胞因于在 两组病人之间无明显差别O均川．lX （）患者 HBVDNA水平随看几七 水平的增高而下降，呈明显负相关关系k一0．9722 ； PN．05儿 其余 三种细胞因子与HBVDNA水平未见相关关系。 结论（1）IL十、IFN－r和 IL刁 可能影响慢乙肝病情发展及预后。 Q）机体的免疫压力似乎对HBVDNA BCP变异无明显影响。 ＊ 机体的 I卜2水平对 HBV复制具有一定的抑制作用。更多还原

【Abstract】 Objective: To probe into the influence IL-2, IFN-r, IL-4 and IL-10 on the state of an illness, replication of HBV and occurrence of HBVDNA BCP mutation in patients with chronic hepatitis B.Methods: Microplate hybridization -ELISA and Fluorescence Quantitative PCR (FQ-PCR) technology were applied to detect HBVDNA BCP mutation and HBVDNA quantity respectively. The level of IL-2, IFN-r, IL-4 and IL-10 in sera was investigated by ELISA method.Results: (1) The results shown that the level of IL-2, IFN-r, IL-4 and IL-10 in the groups of chronic heavy hepatitis B(CHH), chronic hepatitis B ( including light, mediate degreed ) (CH) and liver cirrhosis (LC) was 87. 8±16. 9, 265.8± 228.2, 77.7±95.0,109.8±48.4, 58. 5±20. 5, 73.6±52.6, 66.9±51.8, 77. 2±33.7 and 52.4±20.3, 32.3±27.5, 50.2±35.3, 56.9±34.5 respectively; The level of IL-2, IFN-r and IL-10 in CHH group was significant higher than those in CH and LC groups (P<0. 05), but no significant difference was seen in the leverl of IL-4 (P>0. 05). The level of IL-2, IFN-r, IL-4 and IL-10 in the died and survival patients was 91.0 ± 19. 9, 280.7 ± 243.9, 86.8±101.6, 70. 2 ± 49. 6 and 66. 7 ± 19.0, 93.9 ± 75.9, 61.9 ± 50.6, 75. 1 ± 31.6 respectively. The analysis result showed significant difference between the two groups in the level of IL-2 and IFN-r (P<0. 05), but no significant difference was seen in the level of IL-4 and IL-10 (P>0. 05). (2) The level of IL-2, IFN-r, IL-4 and IL-10 in the HBVDNA BCP mutation and no-mutation groups was 61.4 ± 24.7, 128.3 ± 107.1, 66.3 ± 56.7, 76. 7 ± 54. 5 and 67. 1±24. 3, 93.1±98.7, 59.4 ± 43.3, 72. 5 ± 37. 2 respectively, the matched analysis results showed no significant difference between the two groups (P>0. 1). (3) Thequantity of HBVDNA in sera of patients with chronic hepatitis B was lower with the elevation of the IL-2 level, and showed significant relationship (r=-0. 9722, P<0. 05).Conclusion: (1) The level of IL-2, IFN-r and IL-10 might affect on the development and prognosis of chronic hepatitis B. (2) The immune pressure could be hardly relation to the occurrence of HBVDNA BCP mutation. (3) IL-2 could restrain the replication of hepatitis B virus.更多还原