The Clinical Significance Of Detection The Interleukin-18and NO Change In The Serum Of Chronic Severe Hepatitis B Patients And The Relevant Studies With Entecavir Treatment

Objective To study the mechanisms of interleukin-18(IL-18) and nitric oxide (NO) onpatients with chronic severe hepatitis B (CSHB) in immune injury, and to explore the clinicalsignificance of detecting both of them. To evaluate the impact of entecavir (ETV) with IL-18and NO changes during treating for chronic severe hepatitis B patients, and the clinicaltherapeutic efficacy through the both cytokines in serum and total bilirubin (TBIL), alanineaminotransferase (ALT), albumin (ALB) and prothrombin activity (PTA), hepatitis B vivas-deoxyribonudeic acid (HBV-DNA) changes. Methods (1) Selecting65cases of chronicsevere hepatitis B group at the infections diseases department of the Affiliated Hospital ofNingxia Medical university and The Fifth Hospita of PLA in March2009to March2011,experimental establishment of68cases of normal control group,67cases of chronic hepatitisB group. Detecting the serum level of IL-18by ELISA, while using nitrate reductase methodto measure the serum level of NO, then observe the serum level of IL-18and NO in differentgroups, and used spss13.0for the data analysis.(2)60chronic severe hepatitis B patients ofthe study were randomly divided into two groups, there are treatment group and control group,control group will receive the comprehensive medical treatment and the treatment group willcombined treating with ETV, all of them with no history of antiretroviral therapy. During thetreatment of6weeks later, observing the changes of the serum level of IL-18and NO,detected TBIL,ALT,ALB by automatic biochemical analyzer, detected PTA by automatedcoagulation analyzer, detected serum HBV-DNA carrying adopting real time fluorescentquqntity polymerase chain reaction (RT-PCR) after treatment. Results (1) Compared with normal control group, the serum level of IL-18and NO both increased in chronic severehepatitis B group and chronic hepatitis B group, there were obvious differences in statistical(P<0.01), and it increased more significantly in the CSHB group, it had significantdifferences (P<0.05).(2) There are positive correlation between level of IL-18and NO inchronic severe hepatitis B patients and chronic hepatitis B patients (r=0.83,0.67, P<0.05).(3)The serum level of IL-18and NO decreased both after the treatment, there are a significantdifference that the treatment group decreased significantly more than the control group(P<0.05).(4) After treatment, the total bilirubin (TBIL) and alanine aminotransferase (ALT)decreased than the before between the two groups, prothrombin activity (PTA) and albumin(ALB) increased, there were obvious differences in statistical (P<0.05). The treatment groupcompared to the control group, TBIL and ALT decreased have significantly differences(P<0.01), but there were no significant difference about the increased of PTA and ALB(P>0.05).(5) There were significant differences that the HBV-DNA level in the treatmentgroup decreased significantly than the control group (P<0.01).(6) It was no significantdifference in the efficiency between the treatment group and control group (P>0.05).Conclusion The increasing of serum level of IL-18and NO is closely related to thedevelopment of chronic severe hepatitis B disease. After entecavir treatment, the IL-18andNO level decreased significantly, and inhibited the replication of the hepatitis B virus,improved the clinical and biochemical indicators of the CSHB patients.