余红岚,刘若英,宋静芳,胡大忠,倪飞燕
YU Hong-lan 1; LIU Ruo-ying 1; SONG Jing-fang 1; HU Da-zhong 2; NI Fei-yan 3 (1. Guiyang First People’s Hospital;

• 1:贵阳市第一人民医院
• 2:贵阳市第一人民医院
• 3:贵阳市第一人民医院
• 4:贵阳市第五人民医院

摘要(Abstract)：

目的 :探讨慢性重型乙型肝炎、慢性乙型肝炎、乙型肝炎无症状病毒携带者血清IL 2、IFN γ、IL 4与ALT、IgG、C3 的关系 ,了解乙肝患者肝损伤的病理机制。方法 :6 4份血清用ABC ELISA法测定IL 2、IL 4、IFN γ ,用透射比浊法测定IgG、C3 ,用酶法测定ALT。结果 :(1)血清ALT、IgG水平在无症状病毒携带者、慢性肝炎、慢性重型肝炎中水平逐次增高 ,C3 水平却依此降低 ;(2 )慢性重型肝炎ALT与IL 2、IFN γ有正相关性、与IL 4无显著相关性 ,IgG与IL 4无显著相关性 ,C3 与IL 2、IFN γ负相关 ;慢性肝炎ALT与IL 4、IL 2、IFN γ均无显著相关性 ,IgG与IL 4呈正相关、而与IL 2、IFN γ无相关性 ;(3)动态观察无症状病毒携带者 6月 ,测定以上 5个指标 3次 ,3次结果 5个指标均无显著性差异。结论 :慢性重型肝炎以Th1类细胞因子占优势 ,慢性肝炎以Th2类细胞因子占优势 ,进一步证实肝功能损害的严重程度和Th1的免疫应答的强度有关 ,IgG和C3 随着病情进展而变化。
Objective: To detect the concentrations of partial Th1/Th2 cell factors and to analyze the relationship of ALT, IgG, and C 3 with interleukin 2,4 (IL-2, IL-4), and interferen-γ(IFN-γ) in patients with different clinical types of hepatitis B. Methods: Sixty-four samples of serum were collected from patients with hepatitis B belonging to different clinical types, and IL2,IL4, and IFN-γ were detected by ABC-ELISA method. The immunoglobulin G and complement 3 were also detected by immunoturbidimetry. Results: The IgG levels in chronic sever hepatitis B (CSH) and chronic hepatitis B (CH) were higher than thoes of control group (P<0.01, P<0.05). The levels of C 3 in CSH and CH groups were lower than those of control group (P<0.01, P<0.05). The levels of IgG, and C 3 did not change in asymptomatic hepatitis B group. The level of ALT correlate with levels of IL-2 and IFN-γ in CSH group. The level of IgG correlated with IL-4(P<0.01). Conclusions: Th1 cytokines correlate with hepatic inflammation activity of chronic hepatitis B. The activation of Th1 seems link with injury of liver cells. Th2 cells might associate with the persistence of HBV infection.

关键词(KeyWords)： 肝炎,乙型,慢性;白细胞介素2;白细胞介素4;干扰素Ⅱ型;补体3;丙氨酸转氨酶;免疫球蛋白G
hepatitis B,chronic; interleukin-2; interleukin-4; interferon type Ⅱ; complement 3; alanine transaminase; immunolglobulin G

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 余红岚,刘若英,宋静芳,胡大忠,倪飞燕
YU Hong-lan 1; LIU Ruo-ying 1; SONG Jing-fang 1; HU Da-zhong 2; NI Fei-yan 3 (1. Guiyang First People’s Hospital;

DOI: 10.19367/j.cnki.1000-2707.2004.02.011

参考文献(References)：

• [1]MericanI,guanR ,AnarapukeD ,etal.ChronichepatitisBvirusinfectioninAsincountries[J].JGastroenterolhepatol,2000,15:1356-1361.
• [2]SugimuraT ,motomuraS ,SakaiH ,etal.Increasedserumsolu bleIL 2receptorlevelsfollowinginterferontherapyinpatientswithchronichepatitisc(f)[J].Hepatogestroenterology,1999,46(27):1827-1830.
• [3]AbrignaniS .Antigen independentactivationofrestingT cellsintheliverofpatientswithchronichepatitis[J].DevBoilStand,1998,92:191-194.
• [4]WangJY ,WangXL ,LiuP .DetectionofserumTNF a,IFN γ,IL 6andIL 8inpatientswithhepatitisB [J].WorldGas troenterolJ ,1999,5(1):38-40.
• [5]扬占秋,余宏.临床病毒学[M].北京:中国医药科技出版社,2000.5:152-154.
• [6]第五次全国传染病寄生虫病学术会议.病毒性肝炎防治方案(试行)[J].中华传染病杂志,1995,13:241-246.
• [7]叶应妩.全国临床检验操作规程[M].第2版.北京:人民卫生出版社,1997.215.
• [8]FukudaR ,IishimuraN ,NguyenTX ,etal.TheexpressionofIL 2,IL 4andinterferon gamma(IFN gamma)mRNAusingliverbiopsiesatdifferentphasesofacuteexacerbationofchronichepatitisB [J].ClinExpImmunol,1995,100(3):446-451.
• [9]LeeM ,LeeSK .ExpressionofTh1andTh2typecytokinesre spondingtoHBsAgandHBxAginchronichepatitisBpatients[J].KOreanMedSci,1999,14(2):175-181.
• [10]彭宣宪.激活补体类乙型肝炎病毒表面抗原循环免疫复合物在急性慢性乙型肝炎中的意义[J].病毒学报,1990,6(4):299.
• [11]骆抗先.乙型肝炎基础和临床[M].第2版.北京:人民卫生出版社,2001.5:7.

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