IL-21预测 HBeAg 阳性慢性乙型肝炎患者干扰素治疗应答的价值

摘要

Objective To explore the role of serum IL‐21 levels in predicting the outcomes of interferon(IFN) therapy in the patients with HBeAg positive chronic hepatitis B (CHB) .Methods Sixty‐nine CHB patients with HBeAg positive were treated with IFN for 48 weeks .Serum levels of IL‐21 were detected by ELISA before and in the 12th ,24th ,36th ,and 48th week of IFN treatment .Serum level of HBV‐M was detected by chemiluminescent micropartical immunoassay and that of HBV DNA was detected by fluorescence quantitative PCR .Results Of 69 patients ,22 cases (31.9% ) had complete response(group CR) to IFN therapy with HBeAg disapprearance ,HBeAb apprearance and HBV DNA<500 IU/ml .Another 47 cases(68.1% ) had no complete response(group NCR) .Serum level of IL‐21 before treatment was significantly higher in group CR than that in group NCR (P<0 .05) .Before treatment ,66.7% of CR patients had serum IL‐21 levels ≥110 pg/ml and 80.0%of them had serum IL‐21 levels ≥110 pg/ml as well as HBsAg levels≤3.84 log10 IU/ml .Conclusion High expression of serum IL‐21 predicts a better efficacy of IFN therapy in CHB patients with HBeAg positive .%目的：探讨IL‐21水平在预测干扰素（IFN）治疗慢性乙型肝炎（CHB）疗效中的价值。方法69例HBeAg阳性CHB患者接受IFN治疗48周。ELISA法检测治疗前和治疗12、24、36、48周外周血清IL‐21水平，化学发光微粒子免疫检测法定量检测血清 HBVM ，荧光定量PCR检测血清HBV DNA水平。结果治疗48周时，22例（31.9％）为完全应答（CR）状态，出现 HBeAg血清学转换，且HBV DNA＜500 IU／ml；其余47例（68.1％）为非完全应答（NCR）状态。CR组基线血清IL‐21水平高于NCR组（P＜0．05）。基线IL‐21≥110 pg／ml对CR的预测价值达到66.7％；其中，IL‐21≥110 pg／ml ，且 HBsAg定量≤3.84 log10 IU／ml的CHB患者中80.0％能够实现CR。结论治疗前血清IL‐21高表达的 HBeAg阳性CHB患者预示IFN治疗效果较好。