ITP合并HBV感染患者TNF-α-IL-8-IFN-γ变化意义.doc

ITP合并HBV感染患者TNF-α\IL-8\IFN-γ变化意义[摘要]目的 通过研究感染乙型肝炎病毒（HBV）的特发性血小板减少性紫癜（ITP）患者在抗HBV治疗前后血小板数量、乙型肝炎病毒、白介素-8（IL-8）、肿瘤坏死因子α（TNF-α）、γ干扰素（IFN-γ）量的变化，探讨HBV感染在ITP致病机制中所起的作用。方法选取2009年1月～2010年12月在我院血液科住院的ITP患者80例，其中合并HBV感染的50例，随机分为A、B两组，每组25例，30例HBV阴性的ITP患者为C组。选取30名健康体检者为D组。B、C组患者给予常规ITP治疗，A组患者在常规ITP治疗的同时给予抗HBV治疗，D组不给予任何治疗。检测治疗前后患者血清中血小板总数、IL-8、TNF-α、IFN-γ的变化。结果与C、D组比较，A组同一时间（30d、60d） TNF-α、IFN-γ水平明显升高（P＜0.05）；与B组比较，A组同一时间（30d、60d） TNF-α、IFN-γ水平明显降低（P＜0.05），A组同一时间（30d、60d、90d）血小板计数明显增加（ P＜0.05）。结论HBV感染可能是部分慢性ITP发病的病因，抗HBV治疗对于辅助治疗合并感染HBV的ITP效果较好，故抗病毒治疗可能成为非免疫抑制疗法治疗ITP的一种新选择。 [关键词]特发性血小板减少性紫癜；乙型肝炎病毒；白介素-8；γ干扰素；肿瘤坏死因子α [中图分类号]R512.6+2[文献标识码] A [文章编号] 1673-9701（2011）20-04-02 SignificanceofChangeofSerum TNF-α、IL-8、IFN-γ of Patients with Idiopathic Thiombocytopenic Purpura Complicated with HBV Infection HUANG Wenye ZHANG YunCHEN Yeping Department of Hematology， Yueqing Hospital of Wenzhou Medical College， Yueqing 325600， China [Abstract] Objective To study the effect of the HBV in the pathopoiesia mechanism by comparing the cytokines TNF-α、IL-8、IFN-γ beforeand after the eradication of HBV in ITP patients with HBV.Methods We selected 50 patients of the ITP with HBV infection who were divided into A and B groups. 30 ITP patients without HBV infection were taken as C group，and 30 healthy persons were taken as D group. Patients of A，B and C groups were given conventional ITP therapy. At the same time， patients of group A were given the HBV treatment. Patients of group D were not given any treatment. Before and after the treatment， IL-8、TNF-α、IFN-γwere measured. ResultsCampared with C、D group， the TNF-α、IFN-γ of A group on the same time were higher （P＜0.05）； Compared with B group，the TNF-α、IFN-γ of A group on the same time were lower（P＜0.05），and the platelet of A group on the same time were higher（P＜0.05）. Conclusion HBV infection may be part of the etiology of chronic ITP pathogenesis. The effect of HBV treatment for ITP with HBV were good. So antiviral treatment could b