摘要目的:了解采用干扰素治疗的慢性乙型肝炎(chronic hepatitis B，CHB)患者干扰素受体(interferon-α receptor，IFNAR)、干扰素刺激基因因子3( interferon-stimulated gene factor 3，ISGF3)、双链RNA依赖蛋白激酶(double-stranded RNA-activated protein kinase，PKR)、核糖核酸酶L(ribonuclease L，RNase L)的表达水平。方法:纳入2014年7月至2017年6月南昌大学第一附属医院感染科收治的41例CHB初治患者，18例给予聚乙二醇干扰素α-2b治疗，23例患者给予普通干扰素治疗。采用反转录荧光聚合酶链反应和蛋白质印迹法检测治疗前，治疗4、8、12、24周时患者外周血单个核细胞(peripheral blood mononuclear cell，PBMC)中IFNAR1、IFNAR2、ISGF3、PKR、RNase L的mRNA和蛋白质表达水平。比较治疗有效组和无效组患者上述指标的表达水平。统计学分析采用 t检验。 结果:治疗24周时，25例患者治疗有效，16例治疗无效。治疗4周时，有效组患者PBMC中IFNAR1、IFNAR2和PKR的mRNA表达水平分别为0.748±0.129、1.169±0.125和1.047±0.091，分别高于无效组患者的0.591±0.021、0.689±0.059和0.791±0.033，差异均有统计学意义( t＝-4.304、16.482、-5.346，均 P<0.01)；有效组患者PBMC中ISGF3和RNase L的mRNA表达水平分别为0.739±0.159和0.780±0.140，无效组患者分别为0.690±0.035和0.733±0.122，差异均无统计学意义( t＝-0.160、-1.443，均 P>0.05)。基线，治疗8、12和24周时，有效组患者PBMC中IFNAR1、IFNAR2、ISGF3、PKR和RNase L的mRNA表达水平均高于无效组，差异均有统计学意义(均 P<0.01)。基线，治疗4、8、12和24周时，有效组患者PBMC中IFNAR1、IFNAR2、ISGF3、PKR和RNase L的蛋白质表达水平均高于无效组，差异均有统计学意义(均 P<0.01)。 结论:采用干扰素治疗后，CHB患者PBMC中IFNAR1、IFNAR2、ISGF3、PKR和RNase L的mRNA和蛋白质表达水平均可升高，其中IFNAR2和PKR在治疗早期(4周)即明显升高。

abstractsObjective:To investigate the expression levels of interferon-α receptor (IFNAR), interferon-stimulated gene factor 3(ISGF3), double-stranded RNA-activated protein kinase(PKR) and ribonuclease L (RNase L) in patients with chronic hepatitis B (CHB) treated with interferon.Methods:From July 2014 to June 2017, 41 treatment naive CHB patients were enrolled in the Department of Infectious Diseases, First Affiliated Hospital of Nanchang University. Eighteen patients were treated with polyethylene glycol interferon α-2b, and 23 patients were treated with conventional interferon. The mRNA and protein expression levels of IFNAR1, IFNAR2, ISGF3, PKR and RNase L in peripheral blood mononuclear cells (PBMC) were detected by reverse transcription polymerase chain reaction and Western blot, respectively. The differences of these molecular expression levels in PBMC between the effective and ineffective groups were compared. The data were analyzed by t test. Results:After 24 weeks of treatment, 25 cases were effective, while 16 cases were ineffective. At four weeks of treatment, the mRNA expression levels of IFNAR1, IFNAR2 and PKR in PBMC of the effective group were 0.748±0.129, 1.169±0.125 and 1.047±0.091, respectively, which were all higher than those in the ineffective group (0.591±0.021, 0.689±0.059 and 0.791±0.033, respectively). The differences were statistically significant ( t=-4.304, 16.482 and -5.346, respectively, all P<0.01). The mRNA expressions of ISGF3 and RNase L in PBMC of the effective group were 0.739±0.159 and 0.780±0.140, respectively, while those in the ineffective group were 0.690±0.035 and 0.733±0.122, respectively, which were not significantly different ( t=-0.160 and -1.443, respectively, both P>0.05). The mRNA expression levels of IFNAR1, IFNAR2, ISGF3, PKR and RNase L at baseline, week eight, 12 and 24 of treatment in the effective group were all higher than those in the ineffective group (all P<0.01). The protein expression levels of IFNAR1, IFNAR2, ISGF3, PKR and RNase L in the effective group were all higher than those in the ineffective group (all P<0.01). Conclusion:After interferon treatment, the mRNA and protein expression levels of IFNAR1, IFNAR2, ISGF3, PKR and RNase L in PBMC of CHB patients are all increased, especially IFNAR2 and PKR levels increase in the early stage of treatment (four weeks).