聚乙二醇干扰素治疗丙型肝炎前后淋巴细胞亚群及辅助性T淋巴细胞因子的变化

摘要

目的 研究聚乙二醇干扰素α-2b(PEG-IFNα-2b)治疗慢性丙型肝炎(丙肝)的疗效与机体免疫功能的关系.方法 采用流式细胞仪检测PEG-IFNα-2b治疗前后丙肝患者T淋巴细胞亚群[CD3+、CD4+、CD8+T细胞]及CD4+/CD8+比值、自然杀伤(NK)细胞、细胞毒性T细胞(CTL)的变化;用双抗体夹心酶联免疫吸附试验检测治疗前后患者血清干扰素γ(IFN-γ)、IL-2、IL-6、IL-10的变化.结果 应答组患者治疗前后CD3+、CD4+、CD8+、NK细胞、CTL及CD4+/CD8+比较,差异均有统计学意义(P＜0.01);治疗48周后应答组与无应答组比较,CD3+、CD4+、NK细胞、CD4+/CD8+及IFN-γ、IL-2水平均显著升高,而CD8+、CTL及IL-6、IL-10水平则显著降低,差异均有统计学意义(P＜0.05).结论 PEG-IFNα-2b治疗后患者的细胞免疫功能明显增强,通过检测患者T淋巴细胞亚群、NK细胞、CTL及血清IFN-γ、IL-2、IL-6、IL-10的变化,可以预测患者干扰素治疗的近期疗效.%Objective To study the relationship between the immune state and the efficacy of peg - interferon alfa - 2b ( PEG -IFNa-2b ) of patients with hepatitis C. Methods Using flow cytometry, we studied the changes of T lymphocyte subtypes ( CD3 + , CD4 + , CD8 + ), CD4 +/CD8 + ratio, NK, and CTL in patients with chronic hepatitis C before and after PEG -IFNa - 2b therapy. Using double antibody sandwich ELBA, we studied the changes of serum IFN-γ, IL-2, IL- 6, IL-10 levels in patients with chronic hepatitis C before and after PEG - IFNa - 2b therapy. Results T lymphocyte subtypes ( CD3 +, CD4 + , CD8 + ), CD4 +/CD8 + ratio, NK, and CTL were significantly different before and after treatment in the responder group ( P<0. 01 ). After 48 weeks of treatment, levels of CD3 + cells, CD4 + cells, NK cells, and IFN-7, IL - 2 increased, while CD8 + cells, CTL cells and IL - 6, IL - 10 decreased in the responder group in comparison with the non - responder group ( P < 0. 05 ) . Conclusion The cellular immune function of patients with chronic hepatitis C can be remarkably increased after the treatment of PEG - IFNa - 2b. Changes of T lymphocyte subtypes ( CD3 + , CD4 + , CD8 + ), NK, CTL and serum IFN - γ, IL - 2, IL- 6, IL-10 could predict the short-term curative effects of PEG - IFNa-2b in chronic hepatitis C.