Dynamics of TNF-α and INF-γ content in blood serum in connection with the marker profile of patients with acute hepatitis B at different degrees of severity of the disease

A. Khelemendyk
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Abstract

The aim – is to analyze the dynamics of the content of TNF-α and INF-γ in the serum in connection with the marker profile of patients with acute hepatitis B at different degrees of severity of the disease. Materials and methods. 32 patients with AHB were examined in the dynamics of the disease with the determination of HBsAg, HBeAg, anti-HBs and anti-HBe, the content of TNF-α and IFN-γ by ELISA. Statistical processing was performed in Statistica 13 for Windows (StatSoft Inc., No. JPZ804I382130ARCN10-J). Results. Patients with severe (40.6 %) and moderate (37.5 %) courses of the disease predominate among patients with AHB. Severe course of AHB, compared with the moderate course, was characterized by higher levels of hyperbilirubinemia (P < 0.05), cytolytic syndrome (P < 0.05), hypoproteinemia (P < 0.05), and signs of hypocoagulation (P < 0.05). HBsAg (P < 0.05) was more often observed in patients with moderate and severe AHB (P < 0.05) in the absence of a difference in the frequency of seroconversion for HBeAg. Seroconversion of HBsAg/anti-HBs at 6 months was lowest after mild (66.7 %), compared with moderate (91.7 %) and severe (100.0 %) (P > 0.05) course of the disease. Regardless of the severity of AHB, the content of TNF-α was higher (P < 0.05) than in healthy individuals and highest in the severe course of the disease (P < 0.05). The content of INF-γ was higher than in healthy individuals (P < 0.05), regardless of the severity of the disease. TNF-α correlated with the severity of AHB (r = 0.57, P < 0.05), the level of total bilirubin (r = 0.65, P < 0.05), INR (r = 0.42, P < 0.05) and PI (r = -0.48, P < 0.05) at hospitalization. Conclusions. Patients with severe (40.6 %) and moderate (37.5 %) courses of the disease predominate among the hospitalized patients with AHB. At hospitalization, the content of TNF-α is highest in the severe course of the disease (P < 0.05). The content of INF-γ is higher than in healthy individuals (P < 0.05), regardless of the severity of the course of AHB. At hospitalization, all patients were positive for HBsAg and IgM anti-HBcorAg, the vast majority of patients for HBeAg. Positive HBsAg was more often (P < 0.05) in patients with a moderate course of AHB during discharge from the hospital. HBeAg was preserved in 28.6 % of patients with the mild course. Chronic HBV infection was observed in 3.6 % of patients with the mild course.
急性乙型肝炎不同严重程度患者血清TNF-α和INF-γ含量与标志物谱的动态关系
目的是分析急性乙型肝炎不同严重程度患者血清中TNF-α和INF-γ含量与标志物谱的动态关系。材料和方法。对32例AHB患者进行了疾病动态检测,采用ELISA法检测HBsAg、HBeAg、anti-HBs、anti-HBe及TNF-α、IFN-γ含量。统计处理在Statistica 13 for Windows (StatSoft Inc., No. 5)中进行。.Results JPZ804I382130ARCN10-J)。重度(40.6%)和中度(37.5%)病程的患者在AHB患者中占主导地位。与中度病程相比,重度AHB病程表现为高胆红素血症(P < 0.05)、溶细胞综合征(P < 0.05)、低蛋白血症(P < 0.05)和低凝症状(P < 0.05)。在HBeAg血清转化频率无差异的情况下,中度和重度AHB患者更常观察到HBsAg (P < 0.05) (P < 0.05)。病程轻(66.7%)、中度(91.7%)、重度(100.0%)患者血清HBsAg/抗- hbs转化率最低(P > 0.05)。无论严重程度如何,TNF-α含量均高于健康人(P < 0.05),且在严重病程中含量最高(P < 0.05)。与疾病严重程度无关,tnf -γ含量均高于健康个体(P < 0.05)。TNF-α与住院时AHB严重程度(r = 0.57, P < 0.05)、总胆红素水平(r = 0.65, P < 0.05)、INR (r = 0.42, P < 0.05)、PI (r = -0.48, P < 0.05)相关。在AHB住院患者中,病程严重(40.6%)和中度(37.5%)的患者占主导地位。住院时,肿瘤坏死因子-α含量在危重期最高(P < 0.05)。无论病程严重程度如何,血清中INF-γ含量均高于健康人(P < 0.05)。住院时,所有患者HBsAg和IgM抗hbcorag阳性,绝大多数患者为HBeAg阳性。乙型肝炎中度病程患者出院时HBsAg阳性较多(P < 0.05)。28.6%的轻度病程患者保留HBeAg。在病程较轻的患者中,3.6%的患者存在慢性HBV感染。
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