不同基因分型慢性丙型肝炎患者疾病严重程度分析及免疫活性细胞表达情况

摘要/Abstract

摘要： 目的探究慢性丙型肝炎(CHC)患者的基因分型与疾病严重程度以及免疫活性细胞表达之间的相关性。方法 2021年2月—2023年2月南阳市第一人民医院收治150例CHC患者为研究对象,其中男92例,女58例,年龄40～68岁,平均年龄(45.8±7.2)岁。按照病情不同严重程度将患者划分为CHC轻度组(58例)、中度组(48例)及重度组(44例),同时检测确定各HCV基因型。比较不同病情严重程度、基因型免疫活性细胞表达情况。结果 HCV RNA(+)、HCV RNA(-)CHC患者分别为113例、37例。不同病情严重程度CHC患者HCV RNA(+)、HCV RNA(-)例数比较,差异具有统计学意义(P<0.05)。共检测出HCV基因型为6种,包括1a型15例(10.0%)、1b型61例(40.7%)、2a型59例(39.3%)、2b型7例(4.7%)、3a型3例(2.0%)及6型5例(3.3%),以1b、2a型多见。不同病情严重程度CHC患者各基因型例数比较,差异不具有统计学意义(P>0.05)。鉴于CHC基因2b、3a及6型病例数较少,本研究比较了基因1a、1b及2a型血清IFN-γ、IL-4水平。基因1a、1b及2a型CHC患者血清IFN-γ、IL-4水平比较,差异具有统计学意义(P<0.05)。轻、中、重度CHC患者血清IFN-γ、IL-4水平比较,差异具有统计学意义(P<0.05)。结论 CHC患者具有多种基因型,1b亚型与疾病严重程度以及Th1Th2Th17关系之间存在着密切的联系,同时不同病情严重程度患者免疫活性细胞表达也存在着显著差异。

关键词: 基因分型, 慢性丙型肝炎, 干扰素-γ, 白细胞介素-4, 白细胞介素-17

Abstract: Objective To observe the relationships between the genotypes of hepatitis C virus (HCV) and the severity of disease, and the expression of immune regulatory cytokines in chronic hepatitis C (CHC) patients.Methods Between February 2021 and February 2023, 150 CHC patients treated in Nanyang First People's Hospital were collected in this study, including 92 males and 58 females, aged from 40 to 68 years, with an average age of (45.8±7.2) years. The patients were divided into a mild CHC group (58 cases), a moderate CHC group (48 cases) and a severe CHC group (44 cases) according to the severity of their disease. The HCV genotypes of these patients were determined at the same time. The expression of immunocompetent cells in patients with different severity and genotypes were compared.Results One hundred and thirteen CHC patients were HCV RNA positive and 37 patients were HCV RNA negative. The number of HCV RNA positive and HCV RNA negative cases in CHC patients with different severity was statistically significant (P<0.05). Six HCV genotypes were detected, including 15 cases of type 1a (10.0%), 61 cases of type 1b (40.7%), 59 cases of type 2a (39.3%), 7 cases of type 2b (4.7%), 3 cases of type 3a (2.0%) and 5 cases of type 6 (3.3%). There was no significant difference in the number of cases of CHC patients with different severity (P>0.05). In view of the small number of cases with HCV genotypes 2b, 3a and 6 , the serum IFN-γ. and IL-4 levels were only compared in patients with HCV genotypes 1a, 1b and 2a. The levels of IFN-γ and IL-4 in serum of CHC patients with HCV genotypes 1a, 1b and 2a were significantly different (P<0.05). The levels of serum IFN-γ and IL-4 in patients with mild, moderate and severe CHC were significantly different (P<0.05).Conclusion There are multiple HCV genotypes in CHC patients, and there is a close relationship between subtype 1b and the severity of disease and the expression of Th1/Th2/Th17 cytokines. At the same time, there are significant differences in the expression of immune regulatory cytokines in patients with different severity of the disease.

Key words: Genotype, Chronic hepatitis C, IFN-γ, IL-4, IL-17

蔡晶晶, 杜锴. 不同基因分型慢性丙型肝炎患者疾病严重程度分析及免疫活性细胞表达情况[J]. 肝脏, 2024, 29(12): 1476-1479.

CAI Jing-jing, DU Kai. A study on the relationships between HCV genotypes and the disease severity, and the expression of immune regulatory cytokines in hepatitis C patients[J]. Chinese Hepatolgy, 2024, 29(12): 1476-1479.

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