治疗前血浆趋化因子cxcl9与干扰素治疗慢性乙型.doc

趋化因子与干扰素治疗慢性乙肝病毒学应答的相关性 田小利，秦 波（400016 重庆，重庆医科大学附属第一医院感染科） 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，于首次干扰素治疗前采血，检测血清CXCL9、CXCL10、CCL3、CCL5浓度。患者均接受聚乙二醇干扰素α-2a 180 μg 每周1次治疗，随访治疗3、6个月的疗效。结果Logistic回归分析发现，仅治疗前血清CXCL9AST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39.51 ng/L和CXCL9小于39.51 ng/L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P0.05)；治疗6个月时，率在两组分别为63.16%（12/19）和11.76%（2/17），两组间差异有显著性(P0.05)。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 A Relationship between chemokine levels and virological response to PegIFNα-2a treatment in patients with chronic hepatitis B Tian Xiaoli, Qin Bo (Department of Infectious Diseases, First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China) [Abstract] Objective To elucidate the possible association between serum chemokine levels and virological response to PEGylated interferon (PegIFN) α-2a treatment in patients with chronic hepatitis B. Methods Thirty-six patients infected with genotype B hepatitis B virus (HBV) were recruited in this study. The serum levels of CXCL9, CXCL10, CCL3 and CCL5 were measured by ELISA before treatment. All the patients were treated with PegIFNα-2a 180 ?g every week and were followed up for six months. Results The results of binary logistic regression analysis found that the serum levels of CXCL9 and aspartate aminotransferase (AST) before treatment were the independent predictors for early virological response. The patients were then divided into two groups including a high CXCL9 group (serum level of CXCL939.51 ng/L) and a low CXCL9 group (serum level of CXCL939.51 ng/L). After the treatment for 3 months, the rates of early virological response were 78.95% (15/19) in the high CXCL9 group and 23.53% (4/17) in the low CXCL9 group, respectively (P0.05). After the treatment for 6 months, the rates of maintained virological response were 63.16% (12/19) in the high CXCL9 group and 11.76% (2/17) in the low CXCL9 group, respectively (P0