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目的 探讨Th1/Th2细胞因子在乙型肝炎发病机制中的意义。方法 采集 7例急性病毒性肝炎、12例慢性乙型肝炎、10例慢性重型乙型肝炎患者和 10例健康献血员血清 ;分离 15例慢性乙型肝炎、14例慢性重型乙型肝炎和 10例健康献血员PBMC ,在PHA P刺激下培养 72h ,收取培养上清。采用双抗体夹心ELISA法检测血清和PBMC培养上清IL 2与IL 10水平。结果 急性肝炎血清IL 2高于正常对照 (P <0 .0 1)、高于慢性乙型肝炎 (P <0 .0 5 )、高于慢性重型乙型肝炎 (P <0 .0 5 )。慢性重型乙型肝炎血清IL 2高于正常对照 (P <0 .0 1) ,慢性重型乙型肝炎PBMC培养上清IL 2高于正常对照 (P <0 .0 5 )。血清IL 2与ALT呈正相关 (P <0 .0 1) ,PBMC培养上清IL 2与ALT呈正相关 (P <0 .0 5 )。血清IL 10与PBMC培养上清IL 10与ALT无相关性 ,血清IL 2与IL 10呈正相关 (P <0 .0 1)。结论 Th1型细胞因子IL 2上调与乙型肝炎肝脏的炎症活动相关 ,IL 2的分泌低下可能造成细胞免疫力低下 ,与HBV的持续感染有关。IL 10可能作为IL 2的拮抗因子随IL 2分泌增加而升高。
Objective To investigate the significance of Th1 / Th2 cytokines in the pathogenesis of hepatitis B. Methods Sera from 7 patients with acute viral hepatitis, 12 patients with chronic hepatitis B, 10 patients with chronic severe hepatitis B and 10 healthy blood donors were collected. Fifteen patients with chronic hepatitis B, 14 patients with chronic severe hepatitis B and 10 patients with chronic hepatitis B were enrolled. Healthy blood donors PBMC, cultured in PHA P stimulated 72h, the culture supernatant was collected. Double antibody sandwich ELISA was used to detect IL-2 and IL-10 levels in serum and PBMC culture supernatant. Results Serum IL-2 of acute hepatitis was higher than that of the control (P <0.01), higher than that of chronic hepatitis B (P <0.05) and higher than that of chronic severe hepatitis B (P <0.05). Serum IL-2 of patients with chronic severe hepatitis B was higher than that of controls (P <0.01), and IL-2 in the supernatant of PBMC of patients with chronic severe hepatitis B was higher than that of controls (P <0.05). There was a positive correlation between serum IL-2 and ALT (P <0.01). IL-2 in culture supernatant of PBMC was positively correlated with ALT (P <0.05). There was no correlation between serum IL-10 and culture supernatant of PBMC IL-10 and ALT, and serum IL-2 was positively correlated with IL-10 (P <0.01). Conclusion The up-regulation of Th1-type cytokine IL-2 is associated with the inflammatory activity of hepatitis B liver. The low secretion of IL 2 may result in low cellular immunity and persistent infection with HBV. IL-10 may rise as an antagonist of IL2 with increasing secretion of IL2.