乙醇对慢性丙型肝炎患者hcv基因型分布及肝损害的影响

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1、乙醇对慢性丙型肝炎患者HCV基因型分布及肝损害的影响作者：孙慧慧　王敏　张孝国　陈建　刘靓文　智绪亭【摘要】目的：对比嗜酒与非嗜酒的慢性丙型肝炎(chronichepatitisC，CHC)患者HCVRNA基因型及分布，以明确嗜酒的CHC患者病情发展是否与某种特定基因型有关。检测CHC患者IFN-γ及TNF-α水平，了解嗜酒的HCV感染者肝损害的机制。方法：收集CHC患者114名，分为嗜酒组和非嗜酒组，以基因芯片技术对2组患者进行HCVRNA基因分型。采用Ficoll梯度离心法提取所有患者外周血单个核细胞(PBMC)并培养，

2、ELISA法检测IFN-γ及TNF-α的水平。结果：嗜酒组和非嗜酒组HCVRNA的基因型均以1b型为主(嗜酒组的比例为60%，非嗜酒组为43.75%)，二者之间无统计学意义(P=0.22)。嗜酒组和非嗜酒组的HCVRNA定量测定分别为(11100±14174.3)×103mL-1和(3927.8±4549.6)×103mL-1，二者比较差异有统计学意义(P=0.025)。嗜酒组和非嗜酒组TNF-α水平分别为(4528±3587)ng/L和(3262±3131)ng/L，二者相比差异有统计学意义(P=0.048)，但2组IFN

3、-γ水平差异无统计学意义(P>0.05)。结论：乙醇促CHC肝患者HCVRNA复制，导致肝损伤加重，但并不能增加慢性HCV感染者对某种HCVRNA基因型的易感性。TNF-α在嗜酒的CHC患者中起重要作用，是导致肝损害的重要细胞因子之一。13【关键词】肝炎病毒，丙型·乙醇·基因型·IFN-γ·TNF-α　　【ABSTRACT】Objective：ToanalyzethegenotypesofHCVRNAinalcoholicandnonalcoholicHCVpatientsandcontrastthedistribut

4、ionofthegenotypesbetweenthose,identifyingwhetheralcoholicpatientshaveahighersusceptibilitytocertaingenotypethannonalcoholicpatients.Meanwhile,todetectthelevelofIFN-γandTNF-αforgainingthemechanismofhepaticlesioninalcoholicHCVpatients.Method：114HCVpatients,accordingt

5、othehistoryofalcoholabuse,weredividedintothealcoholgroupandnonalcoholgroup.ThegenotypesofHCVRNAinthetwogroupswereperformedbygenechiptechnique.Liverbiopsywaspracticedin30patientstodiagnose.FicollgradientcentrifugationandELISAwereusedforextractionofPBMCanddetectionof

6、IFN-γandTNF-α,respectively.Result：Thegenotype1bwasgreaterthanothergenotypesinthetwogroups,andtherewasnostatisticalsignificance(Alcoholgroupwas60%andnonalcoholgroupwas43.75%,P=0.22).TheserumtitersofHCVRNAofalcoholgroupwere(11100±14174.3)×103copies/mlandthenonalcohol

7、groupwere(3927.8±4549.6)×103copies/ml,andtherewasstatisticalsignificancebetweenthetwogroups(P=0.025).Among1813alcoholicpatientsof30patientspracticedliverbiopsy,theirliverinflammationwashigherthannonalcoholicpatients.ThelevelofTNF-αofthealcoholwashigherthanthatofnon

8、alcohol,therewasstatisticalsignificancebetweenthetwogroups(P=0.048)andnostatisticalsignificancebetweenthoseofIFN-γ.Conclusion：Alcoholcanpromoteth