【作者】 王媛媛；

【导师】 韩涛； 朱争艳；

【作者基本信息】 天津医科大学 ， 内科学， 2008， 硕士

【摘要】 一、研究慢乙肝患者Treg的表达与核苷类似物的疗效的关系。目的:研究慢乙肝患者Treg的表达与核苷类似物的疗效的关系。方法:用流式细胞仪检测慢乙肝患者CD4⁺CD127^loCD25^hi-int调节性T细胞占CD4⁺T淋巴细胞的百分比。比较经核苷类似物治疗后不同疗效间CD4⁺CD127^loCD25^hi-int调节性T细胞的表达情况。结果:经核苷类似物治疗后,无效组调节性T细胞（Treg）水平显著高于有效组及健康对照组,差别有统计学意义（P值分别为0.004,0.000）,有效组与健康对照组之间Treg的差别无统计学意义（P＞0.05）。结论:慢乙肝患者的Treg能够抑制机体特异的抗病毒免疫反应,所以Treg的高表达可能与HBV-DNA的高载量相关。经核苷类似物治疗后Treg的下降与低表达可能导致慢乙肝患者免疫功能的部分恢复,以利于机体内病毒的清除。因此,检测患者Treg并结合一些其它的免疫指标,将对预测核苷类似物患者远期抗病毒疗效提供一定的帮助。二、研究慢乙肝患者IL-10,IFN-γ的表达与核苷类似物疗效的关系。目的:研究慢乙肝患者IL-10,IFN-γ的表达与核苷类似物疗效的关系。方法:用ELISA方法检测慢乙肝患者IL-10、IFN-γ。比较经核苷类似物治疗后不同疗效间IL-10、IFN-γ水平的差异。结果:经核苷类似物治疗后,有效组的IFN-γ水平高于无效组及健康对照组,差别有统计学意义（P值均为0.000）,无效组的IFN-γ与健康对照组相比,差别无统计学意义（P＞0.05）;经核苷类似物治疗后,有效组IL-10低于无效组,差别有统计学意义（P=0.000）,两组的IL-10均较健康对照组低,差别有统计学意义（P值分别为0.000,0.028）。结论:核苷类似物治疗的疗效与IL-10与IFN-γ有一定的关系。有效组机体内反映抗病毒作用的细胞免疫指标IFN-γ的水平升高,与之相反的不利于抗病毒作用的指标IL-10的水平下降。IFN-γ是Th1细胞分泌的细胞因子,它的升高促进机体的Th1/Th2细胞之间平衡的恢复,促进机体的Th1细胞占优势,以利于机体抗病毒作用的发挥。IL-10是Th2细胞分泌的细胞因子,IL-10的降低将恢复Th1细胞的优势,降低Th2的优势,以利于机体发挥抗病毒的免疫反应。本文有关核苷类似物治疗后IL-10与IFN-γ的研究将为以后初步预测核苷类似物的疗效提供一定的帮助。更多还原

【Abstract】 Ⅰ.Relationship between regulatory thymus cell in chronic hepatitis B patients and Nucleoside Analogues’ efficacyObjective:To study relationship between regulatory thymus cell in chronic hepatitis B patients and Nucleoside Analogues’ efficacy.Method:CD4⁺CD127^loCD25^hi-intregulatory thymus cell（Treg）was tested by Flow Cytometry.Compare Treg in patients with chronic hepatitis B virus infection under different Nucleoside Analogues’ efficacy.Result:Treg of inefficacious patients was significantly higher than eutherapeutic patients and healthy control group after Nucleoside Analogues treatment（p=0.004, p=0.000,respectively）.Difference of Treg between eutherapeutic patients after Nucleoside Analogues treatment and healthy control group was showing no significant（p＞0.05）.Conclusion:Treg of chronic hepatitis B can inhibit antiviral immune response,so the high expression of Treg was correlated with the high viral load in chronic hepatitis B virus infection.The low expression and decrease of Treg could result in partial recovery of immune function in chronic hepatitis B after Nucleoside Analogue treatment,so it would be beneficial to viral clearance.Detection Treg and other immune index would provide help for preliminary prediction efficacy of Nucleoside Analogue treatment.Ⅱ:Relationship between Interferon-γ（IFN-γ）and Interleukin-10（IL-10）in chronic hepatitis B patients and Nucleoside Analogues’ efficacyObjective:To study relationship between IFN-γand IL-10 in chronic hepatitis B patients with and Nucleoside Analogues’ efficacy.Method:IFN-γand IL-10 in chronic hepatitis B patients after Nucleoside Analogue treatment testing by Enzyme-linked Immunosorbent Assay（ELISA）.Compare the IFN-γand IL-10 in chronic hepatitis B patients under different Nucleoside Analogues efficacy.Result:IFN-γof eutherapeutic patients was significantly higher than inefficacious patients and healthy control group（p=0.000,p=0.000,respectively）.Differences of IFN-γbetween inefficacious patients and healthy control group was no significant（ p＞0.05）.IL-10 of eutherapeutic patients was significantly lower than inefficacious patients（p=0.000）.IL-10 of eutherapeutic patients and inefficacious patients after Nucleoside Analogue treatment was significantly lower than healthy control group （p=0.000,p=0.028,respectively）.Conclusion:IFN-γand IL-10 was correlated with efficacy of Nucleoside Analogues treatment.IFN-γwhich inflects antiviral immune response was increased.IL-10 which go against antiviral immune response was decreased.IFN-γwas secreted by thymus helper 1（Th1）cell.The increased of IFN-γpromote the balance of Th1/Th2, which was beneficial to viral clearance.IL-10 was secreted by Th2 cell.The decreased of IL-10 recovered the superiority of Th1,which was beneficial to viral clearance.This study about IFN-γand IL-10 would provide help for preliminary prediction of Nucleoside Analogues’ efficacy.更多还原