目的 通过检测接受不同治疗方案的慢乙肝患者的血清白介素21(IL-21)水平,探讨药物对IL-21表达的影响.方法 198例非活动性慢乙肝患者分为干扰素治疗组(IFN,n=38)、核苷类似物治疗组(NA,n=72)和未接受任何抗病毒治疗对照组(Con,n=88).采用ELISA法定量测定IL-21.肝功能指标均采用全自动生化分析仪检测.HBV血清标志物(HBsAg、HBsAb、HBeAg、HBeAb、HBcAb)采用ELISA方法检测.结果 对照组和干扰素治疗组IL-21水平都显著高于核苷类似物治疗组(P＜0.05),依次为(102.29±14.03)、(123.01±38.26)、(48.10±7.06) pg/ml.HBeAg阴性组(n=105)的IL-21水平显著高于HBeAg阳性组(n=93),依次为(114.83±19.88)pg/ml、(61.53±6.61) pg/ml (P＜0.05).IL-21与肝功能各项指标之间无显著相关性.结论 免疫调节剂干扰素可能具有上调慢乙肝患者IL-21水平的作用,而核苷类似物具有下调作用.HBeAg阴性组的IL-21水平显著高于阳性组,表明HBeAg抗原表达时IL-21水平降低.%Objective To detect serum interleukin-21 (IL-21) levels in patients with chronic hepatitis B receiving different therapeutic regimens. Methods A total of 198 patients with inactive chronic hepatitis B were divided into 3 groups according to the therapeutic regimens, namely interferon (IFN)-treated group (IFN group, n=38), nucleoside analogue-treated group (NA group, n=72) and untreated group (control group, n=88). IL-21 and serum hepatitis B virus (HBV) markers were detected in these patients using enzyme-linked immunosorbent assay (ELISA), and the liver function indices were measured with an auto-biochemical analyzer. Results The serum IL-21 levels in Con and IFN groups were significantly higher than those in NA group (102.29±4.03,123.01±8.26, and 48.10±.06 pg/ml, respectively, P<0.05). When all the patients were regrouped according to the status of HBeAg, serum IL-21 level was 114.83±9.88 pg/ml in HBeAg-negative group (n=105), significantly higher than that of 61.53 ±6.61 pg/ml in HBeAg-positive group (n=93) (P<0.05). Bivariate correlation analysis showed no significant correlations between IL-21 and liver function indices. Conclusion The immunomodulator IFN might be capable of increasing serum IL-21 levels, while nucleoside analogues can decrease IL-21 level in patients with chronic hepatitis B. HBeAg-negative patients have a significantly higher serum IL-21 level, suggesting that the expression of HBeAg might result in IL-21 depression.
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