趋化因子与慢性乙肝干扰素治疗应答的相关性.docVIP

趋化因子与慢干扰素的相关性 田小利 秦 波（400016 重庆，重庆医科大学附属第一医院感染科） [基金项目]CSTC2008BB5079）； 重庆市卫生局重点项目 (2011-1-040) [通讯作者] 秦波，电话：，E-mail：cqqinbo@126.com [ 摘要 ] 目的：探索趋化因子水平和慢乙肝患者干扰素治疗病毒学应答之间的相关性。方法：纳入基因型为B型的慢性乙肝患者36名，于首次干扰素治疗前采血，检测血清CXCL9、CXCL10、CCL3、CCL5浓度。所有患者均接受聚乙二醇干扰素α-2a 180ug 每周一次治疗，随访治疗6个月的疗效。结果：多因素logistic回归分析发现，仅治疗前血清CXCL9是早期病毒学应答的独立预测指标。将患者分为血清CXCL9大于39.51ng/l和CXCL9小于39.51ng/l两组，治疗3个月时，两组的早期病毒学应答率分别为78.95%（15/19）和23.53%(4/17)，两组间差异有显著性；治疗6个月时，率在两组分别为63.16%（12/19）和17.65%（3/17），两组间差异有显著性。结论： CXCL9表达水平较高的患者经聚乙二醇干扰素治疗后病毒学应答率较高，可能有利于指导慢性乙型肝炎患者的个体化用药。 [ 关键词 ] 慢性乙；干扰素；趋化因子 Relationship between chemokine levels and viral response to PegIFNα-2a treatment in patients with chronic hepatitis B Tian Xiaoli Qin Bo (Department of Infectious Diseases, The First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016,China) [ Abstract ] Objective To elucidate the possible association between serum chemokine levels and response to PegIFNα-2a treatment in patients with chronic hepatitis B. Methods 36 patients with chronic HBV genotype B infection were recruited to this study，serum CXCL9、CXCL10、CCL3 and CCL5 concentrations were measured by an ELISA method at basline. All patients received PegIFNα-2a 180ug every week and followed up for six months. Results By multivariate logistic regression analysis of all patients, we found that pretreatment serum CXCL9 was independent predictor for early virological response. At month 3, the rates of early virological response was 78.95%（15/19）and 23.53% (4/17) in patients whose baseline serum CXCL9 was higher and lower than 39.51 ng/l respectively(p0.05); At month 6, the rates of maintained respons was 63.16%（12/19） and 17.65%（3/17） in patients whose baseline serum CXCL9 was higher and lower than 39.51 ng/l respectively(p0.05). Conclusion There are better outcome of PegIFNα-2a therapy for patients with higher CXCL9 expression, so detection of serum CXCL9 baseline may help to improve the efficacy of PegIFNα-2a therapy for pati