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ITP合并HBV感染患者TNF-α\IL-8\IFN-γ变化的意义(1)
http://www.100md.com 2011年7月15日 黄文烨 张蕴 陈冶平
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     [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 become a new choice for ITP .

    [Key words]Idiopathi cthiombocytopenic purpura(ITP);Hepatitis B virus(HBV); Interleukin-8(IL-8);Interferonγ (IFN-γ);Tumornecrosis factor α(TNF-α) ......

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