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目的 :探讨慢性乙肝 (CHB)患者血清及经乙肝疫苗刺激后外周血单个核细胞 (PBMCs)培养上清γ干扰素 (γ -IFN)和白细胞介素 - 4 (IL - 4 )水平及临床意义。方法 :分离 13例CHB患者及 10名正常人PBMCs。PBMCs体外单独培养或与乙肝疫苗共培养 4 8小时后 ,检测血清及培养上清中γ -IFN和IL - 4水平。结果 :在血清、空白处理的PBMCs培养上清 ,以及乙肝疫苗处理后的PBMCs培养上清中 ,慢性乙肝患者的IL - 4水平均较对照组高 ,而γ -IFN水平均比对照组低 ;同时 ,经乙肝疫苗处理后病例组和对照组PBMCs培养上清中IL - 4水平都较空白处理组显著增高 ,尤以病例组明显 ;经乙肝疫苗处理后 ,病例组和对照组PBMCs培养上清中γ -IFN水平无明显增高。结论 :慢性乙肝患者Th1和Th2应答失衡 ,以Th2应答为优势 ;重组乙肝疫苗能够增强慢性乙肝患者Th2应答 ;慢性乙肝患者血清中可能存在抑制免疫应答的物质 ;重组乙肝疫苗可能不包含能够刺激Th1应答的表位
Objective: To investigate the serum levels of γ - IFN and interleukin - 4 (IL - 4) in serum of patients with chronic hepatitis B (CHB) and peripheral blood mononuclear cells (PBMCs) stimulated by hepatitis B vaccine and their clinical significance . Methods: Thirteen CHB patients and 10 normal human PBMCs were isolated. PBMCs were cultured alone or in co-culture with hepatitis B vaccine for 48 hours. The levels of γ-IFN and IL-4 in serum and culture supernatants were detected. Results: The levels of IL - 4 in serum, PBMC culture supernatant of blank control group and PBMC culture supernatant of Hepatitis B vaccine group were higher than those in control group, but the level of γ - IFN was lower than that in control group. At the same time, the level of IL - 4 in the supernatant of PBMCs treated by Hepatitis B vaccine was significantly higher than that of the blank control group, especially in the case group. After treatment with Hepatitis B vaccine, the level of IL - Γ-IFN level no significant increase. Conclusion: The imbalance of Th1 and Th2 in patients with chronic hepatitis B is the predominance of Th2 response. Recombinant hepatitis B vaccine can enhance the Th2 response in patients with chronic hepatitis B. Serum of patients with chronic hepatitis B may have substances that suppress immune response. Recombinant hepatitis B vaccine may not contain Th1 Epitope of response