【摘要】：目的：通過檢測丙型肝炎肝硬化患者、慢性丙型肝炎患者和正常對(duì)照組血清中ALT、AST、TBil以及細(xì)胞因子IL-17濃度水平變化,及不同患病組IL-17與ALT、AST、 TBil的相關(guān)性研究,探討在丙型肝炎疾病發(fā)展的不同階段的變化特點(diǎn)。按照病毒載量分組的研究,探討病毒載量與IL-17、ALT、AST、TBil之間的相關(guān)性。同時(shí)比較抗病毒治療前后患者細(xì)胞因子IL-17的變化,探討IL-17在丙型肝炎的發(fā)病機(jī)制方面的作用的研究。方法：85例丙型肝炎患者其中包括24例丙型肝炎肝硬化患者和61例慢性丙型肝炎患者,選擇其中20例病毒載量1×103的丙型肝炎患者進(jìn)行聚乙醇干擾素聯(lián)合利巴韋林治療療效觀察,同期30例健康人作為對(duì)照。所有丙型肝炎患者抗-HCV抗體檢測S/C03.8(排除抗-HCV假陽性患者),將研究對(duì)象分為4組進(jìn)行研究。采用全自動(dòng)生化分析儀檢測所有研究對(duì)象的ALT、AST、TBil的水平,采用酶聯(lián)免疫吸附實(shí)驗(yàn)-雙抗體夾心法(ELISA)檢測所有研究對(duì)象血清中抗-HCV抗體和細(xì)胞因子IL-17水平。采用熒光定量聚合酶鏈反應(yīng)(RT-PCR)檢測HCV-RNA的病毒載量。結(jié)果：(1)通過多組兩兩比較結(jié)果,IL-17、ALT、AST、TBil水平Ⅱ組、Ⅲ組與Ⅳ組(健康對(duì)照組)相比P(0.05,Ⅲ組與Ⅰ組相比P0.05,差異具有統(tǒng)計(jì)學(xué)意義。IL-17、ALT、AST水平II組與I組相比P0.05,IL-17水平I組與IV組(健康對(duì)照組)相比P0.05,差異具有統(tǒng)計(jì)學(xué)意義。各組IL-17水平與ALT、AST、TBil水平做相關(guān)性分析,結(jié)果顯示Ⅱ組(抗-HCV(+),HCV-RNA1×103)IL-17水平與ALT、AST、TBil水平之間呈正相關(guān)(r=0.579,r=0.516,r=0.203)。(2)按照病毒載量HCV-RNA高低分組,病毒載量與IL-17水平呈正相關(guān),隨著病毒載量的升高IL-17水平也隨之升高。(3)治療前后IL-17、ALT、AST水平比較P0.05,差異有統(tǒng)計(jì)學(xué)意義。經(jīng)抗病毒治療后ALT、AST濃度的均值水平下降,IL-17水平上升。結(jié)論：患者組IL-17、ALT、AST、TBil的檢測水平較健康對(duì)照組有所增高,可能與患者肝細(xì)胞的炎性損傷有關(guān),同時(shí)II組IL-17水平與ALT、AST、TBil的水平變化呈正相關(guān),說明IL-17在一定程度上能夠反映肝臟的損傷程度。經(jīng)抗病毒治療后患者ALT、AST水平下降,說明肝細(xì)胞的炎性反應(yīng)程度有所緩解,IL-17水平升高,說明IL-17不僅參與了炎性反應(yīng)的發(fā)生過程,而且在炎癥緩解的過程中也發(fā)揮著重要的作用,為臨床提供了新的治療依據(jù)。
[Abstract]:Objective: to study the changes of serum ALT,AST,TBil and cytokine IL-17 levels in patients with hepatitis C cirrhosis, chronic hepatitis C patients and normal controls, and the correlation between IL-17 and ALT,AST, TBil in different groups. To explore the characteristics of hepatitis C disease at different stages of development. The correlation between viral load and IL-17,ALT,AST,TBil was discussed according to the study of viral load grouping. The changes of cytokine IL-17 before and after antiviral therapy were compared to explore the role of IL-17 in the pathogenesis of hepatitis C. Methods: 85 patients with hepatitis C, including 24 patients with cirrhosis of hepatitis C and 61 patients with chronic hepatitis C. 20 patients with hepatitis C with viral load of 1 脳 103 were treated with interferon polyethanol combined with ribavirin. In the same period, 30 healthy persons were used as control. All patients with hepatitis C were tested for anti-HCV antibody (excluding anti-HCV false positive patients) and the subjects were divided into 4 groups. The levels of ALT,AST,TBil in all subjects were detected by automatic biochemical analyzer, and the levels of anti HCV antibody and cytokine IL-17 in serum of all subjects were detected by enzyme linked immunosorbent assay (Elisa) and double antibody sandwich method (ELISA). The viral load of HCV-RNA was detected by fluorescence quantitative polymerase chain reaction (RT-PCR). Results: (1) the IL-17,ALT,AST,TBil level of group 鈪，

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