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干扰素λ3在慢性乙型肝炎患者血清中的表达及临床意义
Serum level of interferon-λ3 in patients with chronic hepatitis B and its clinical significance
文章发布日期:2019年01月07日  来源:  作者:段元丽,管世鹤,杨凯,等  点击次数:358次  下载次数:57次

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【摘要】:目的 了解慢性乙型肝炎患者血清IFNλ3水平,探究其临床意义及其与核苷和核苷酸类药物治疗的关系。方法 选取2017年1月-2018年5月在安徽医科大学第二附属医院就诊的慢性乙型肝炎患者119例,收集同期HBsAg阴性的22例健康体检者作为健康对照。采用ELISA法检测血清中IFNλ3的表达水平,比较慢性乙型肝炎患者与健康人血清IFNλ3水平差异,分析慢性乙型肝炎患者血清IFNλ3水平与HBeAg的关系,观察不同核苷和核苷酸类药物治疗慢性乙型肝炎患者的血清IFNλ3水平,以及核苷和核苷酸类药物对外周血单个核细胞培养上清中IFNλ3水平的影响。 满足正态性和方差齐性的计量资料多组间比较采用方差分析;对非正态或方差不齐的计量资料,两组比较采用Wilcoxon秩和检验,多组比较采用Kruskal-Wallis H检验,进一步两两比较采用Nemenyi法检验。相关性分析用Spearman相关性分析法。结果 慢性乙型肝炎患者血清IFNλ3水平明显低于健康对照组[14.7(5.9~28.5)pg/ml vs 76.1(39.4~112.0)pg/ml,Z=-10.114,P<0.001]。未抗病毒治疗的慢性乙型肝炎患者血清IFNλ3水平与log HBV DNA呈负相关(r=-0.621,P<0.001)。HBeAg阴性慢性乙型肝炎患者血清IFNλ3水平高于HBeAg阳性患者,2组间差异有统计学意义[16.4(9.0~31.3)pg/ml vs 8.7(2.9~23.2)pg/ml,Z=-2.205,P=0.02]。服用阿德福韦酯抗病毒治疗的患者血清IFNλ3水平显著高于服用恩替卡韦、替诺福韦、替比夫定、拉米夫定治疗的患者,差异均有统计学意义(P值均<0.05);体外实验核苷和核苷酸类药物处理的外周血单个核细胞培养上清中未见IFNλ3水平明显升高。 结论 慢性乙型肝炎患者血清IFNλ3显著低于健康人群,阿德福韦酯抗病毒治疗患者具有较高的血清IFNλ3水平。
【Abstract】:Objective To investigate the serum level of interferon-λ3 (IFN-λ3) and its clinical significance in patients with chronic hepatitis B (CHB), as well as its association with nucleos(t)ide analogue (NA) treatment. Methods A total of 119 CHB patients who were treated in The Second Affiliated Hospital of Anhui Medical University from January 2017 to May 2018 were enrolled, and 22 HBsAg-negative individuals who underwent physical examination were enrolled as healthy control group. ELISA was used to measure the serum level of IFN-λ3, which was compared between CHB patients and healthy individuals. The association between serum IFN-λ3 level and HBeAg in CHB patients was analyzed; serum IFN-λ3 level was compared between the patients treated with different NAs; the influence of NAs on the level of IFN-λ3 in the supernatant of peripheral blood mononuclear cells (PBMCs) was analyzed. An analysis of variance was used for comparison of normally distributed continuous data with homogeneity of variance between multiple groups; the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data or continuous data with heterogeneity of variance between two groups, the Kruskal-Wallis H test was used for comparison between multiple groups, and the Nemenyi test was used for further comparison between two groups. A Spearman correlation analysis was also performed. Results The CHB group had a significantly lower serum IFN-λ3 level than the healthy control group [14.7 (5.9-28.5) pg/ml vs 76.1 (39.4-112.0) pg/ml, Z=-10.114, P<0.001]. In the CHB patients who did not receive antiviral therapy, serum IFN-λ3 level was negatively correlated with log HBV DNA (r=-0.621, P<0.001). The HBeAg-negative CHB patients had a significantly higher serum IFN-λ3 level than the HBeAg-positive CHB patients [16.4 (9.0-31.3) pg/ml vs 8.7 (2.9-23.2) pg/ml, Z=-2.205, P=0.02]. The patients who received antiviral therapy with adefovir dipivoxil had a significantly higher serum IFN-λ3 level than those who were treated with entecavir, tenofovir, telbivudine, or lamivudine (P<0.05). In vitro experiment showed that there was no significant increase in serum IFN-λ3 level in the supernatant of PBMCs treated with NAs. Conclusion CHB patients have a significantly lower serum IFN-λ3 level than healthy individuals, and the CHB patients receiving antiviral therapy with adefovir dipivoxil have a relatively high serum IFN-λ3 level.
【关键字】:肝炎, 乙型, 慢性; 干扰素类
【Key words】:hepatitis B, chronic; interferons
【引证本文】:DUAN YL, GUAN SH, YANG K, et al. Serum level of interferon-λ3 in patients with chronic hepatitis B and its clinical significance[J]. J Clin Hepatol, 2019, 35(2): 315-318. (in Chinese)
段元丽, 管世鹤, 杨凯, 等. 干扰素λ3在慢性乙型肝炎患者血清中的表达及临床意义[J]. 临床肝胆病杂志, 2019, 35(2): 315-318.

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