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目的探讨IL-21水平在预测干扰素(IFN)治疗慢性乙型肝炎(CHB)疗效中的价值。方法 69例HBeAg阳性CHB患者接受IFN治疗48周。ELISA法检测治疗前和治疗12、24、36、48周外周血清IL-21水平,化学发光微粒子免疫检测法定量检测血清HBVM,荧光定量PCR检测血清HBV DNA水平。结果治疗48周时,22例(31.9%)为完全应答(CR)状态,出现HBeAg血清学转换,且HBV DNA<500IU/ml;其余47例(68.1%)为非完全应答(NCR)状态。CR组基线血清IL-21水平高于NCR组(P<0.05)。基线IL-21≥110pg/ml对CR的预测价值达到66.7%;其中,IL-21≥110pg/ml,且HBsAg定量≤3.84log_(10)IU/ml的CHB患者中80.0%能够实现CR。结论治疗前血清IL-21高表达的HBeAg阳性CHB患者预示IFN治疗效果较好。
Objective To investigate the value of IL-21 in predicting the efficacy of interferon (IFN) in the treatment of chronic hepatitis B (CHB). Methods Sixty-nine HBeAg-positive CHB patients were treated with IFN for 48 weeks. The levels of IL-21 in peripheral blood before treatment and 12,24,36,48 weeks of treatment were detected by ELISA, serum HBVM level was detected by chemiluminescence microparticle immunoassay, and serum HBV DNA was detected by quantitative PCR. Results At week 48, 22 patients (31.9%) had complete response (CR), HBeAg seroconversion, and HBV DNA <500 IU / ml; the remaining 47 patients (68.1%) had non-complete response (NCR) status. Serum levels of IL-21 in CR group were significantly higher than those in NCR group (P <0.05). The predictive value of baseline IL-21≥110 pg / ml on CR reached 66.7%. Among them, 80.0% of CHB patients with IL-21≥110 pg / ml and HBsAg quantitation≤3.84log_ (10) IU / ml achieved CR. Conclusion The HBeAg-positive CHB patients with high serum IL-21 level before treatment indicate that IFN treatment is better.