细胞因子和病毒标志物对聚乙二醇干扰素治疗HBeAg阳性慢性乙型肝炎的意义

摘要/Abstract

摘要： 目的探究细胞因子和病毒标志物在监测聚乙二醇干扰素治疗HBeAg阳性慢性乙型肝炎(CHB)中的意义。方法选取2020年1月至2022年5月武威市中医医院收治的HBeAg阳性CHB患者117例。比较PEG-IFN治疗前、治疗24周和48周时的临床生化指标、HBV血清学指标以及细胞因子。结果 117例患者中,血清HBeAg应答46例,未应答71例。应答组中HBsAg转阴23例,未应答组中HBsAg转阴17例。应答组和未应答组病毒学标志物和细胞因子水平相近,在24周时未应答组AST、ALT、TNF-α、TGF-β分别为(43.1±12.9)U/L、(56.58±8.2)U/L、(20.4±2.9)pg/mL、(3279±960.8)pg/mL,下降幅度均小于应答组的(33.4±7.4)U/L、(41.6±8.3)U/L、(15.4±2.8)pg/mL、(2610.8±705.6)pg/mL(均P<0.05)。治疗48周时未应答组AST、ALT、TNF-α、TGF-β、IL-10分别为(35.2±7.7)U/L、(33.2±9.5)U/L、(16.6±3.7)pg/mL、(3180.6±1040.9)pg/mL、(4.4±2.7)pg/mL,下降幅度均小于应答组的(27.2±6.9)U/L、(29.1±8.1)U/L、(13.8±2.5)pg/mL、(1975.0±474.0)pg/mL、(3.0±0.9)pg/mL(均P<0.05),而应答组IFN-γ为(530.9±146.5)pg/mL,高于未应答组(467.8±147.8)pg/mL(P<0.05)。结论 TNF-α、TGF-β在治疗前后均与血清HBeAg具有相关性,有成为预测PEG-IFN治疗HBeAg阳性CHB疗效指标的潜在可能性,IFN在早期治疗不具有相关性,治疗48周后呈中度正相关,提示IFN可能是预测晚期疗效的指标。

关键词: HBeAg阳性慢性乙型肝炎, 聚乙二醇干扰素, 细胞因子, 病毒学标志物

Abstract: Objective To investigate the significance of cytokine profiles and virological markers in guiding peginterferon therapy for HBeAg-positive chronic hepatitis B(CHB).Methods Between January 2020 and May 2022, HBeAg-positive CHB patients were selected from our hospital based on meeting the diagnostic criteria for inclustion in the study. These patients underwent 48-week treatment with PEG-IFN. Clinical biochemical parameters, HBV serological indices, and cytokine levels were assessed at baseline, 24 weeks, and 48 weeks respectively.Results In our study, 117 HBeAg-positive patients with chronic hepatitis B were enrolled. Of these, 46 demonstrated serum HBeAg responses,while 71 showed non-responses. Within the serumHBsAg responses group, 23 showed HBeAg responses, compared to 17 in the non-response group. Viral marker and cytokine levels were comparable between the HBeAg response and non-response groups. However, at the 24-week mark, the non-response group exhibited lower AST, ALT, TNF-α, TGF-β levels[(43.1±12.9)U/L, (56.58±8.2)U/L, (20.4±2.9) pg/mL, and(3279±960.8)pg/mL] than the response group [(33.4±7.4)U/L, (41.6±8.3)U/L, (15.4±2.8)pg/mL、and(2610.8±705.6)pg/mL],with P＜0.05. By the 48-week treatment mark, AST, ALT, TNF-α, TGF-β, and IL-10 leves[(35.2±7.7)U/L, (33.2±9.5)U/L, (16.6±3.7)pg/mL, (3180.6±1040.9)pg/mL, and(4.4±2.7)pg/mL] in the non-response group dereased less than in the response group[(27.2±6.9)U/L, (29.1±8.1)U/L, (13.8±2.5) pg/mL, (1975.0±474.0)pg/mL, and(3.0±0.9)pg/mL], with P<0.05. Notably, the IFN-γ level in the non-response group[(530.9±146.5)pg/mL] increased more than in the response group [(467.8±147.8)pg/mL], with P<0.05.Conclusion The cytokines TNF-α and TGF-β demonstrated a correlation with serum HBeAg both pre-and post-treatment, suggesting their potential as clinical markers for predicting PEG-IFN efficacy.

Key words: HBeAg-positive chronic hepatitis B, Peginterferon, Cytokines, Virological marker

孙瑞花, 郝文杰, 张跃军, 张长菊. 细胞因子和病毒标志物对聚乙二醇干扰素治疗HBeAg阳性慢性乙型肝炎的意义[J]. 肝脏, 2023, 28(11): 1335-1338.

SUN Rui-hua, HAO Wen-jie, ZHANG Yue-jun, ZHANG Chang-ju. Significance of cytokine profiling and virological markers in guiding peginterferon therapy for HBeAg-positive chronic hepatitis B[J]. Chinese Hepatolgy, 2023, 28(11): 1335-1338.

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