摘要
目的分析比较乙型肝炎肝硬化患者血清细胞因子水平变化及其与疾病进展的关系。方法2014年9月~2016年8月我院收治的79例乙型肝炎肝硬化患者,其中Child-PughA级31例,B级25例,C级23例,另选体检健康人23例作为对照,采用ELISA法检测血清IL-2、IL-6、IL-10和可溶性细胞间黏附分子-1(sICAM-1)。结果代偿期肝硬化和失代偿期肝硬化患者血清IL-10水平水平分别为(43.5±8.4)g/L和(55.8±6.1)g/L,显著低于健康人【(247.1±43.4)g/L,P<0.01】,而血清IL-2、IL-6和sICAM-1水平分别为(148.1±21.3)g/L、(43.5±8.4)g/L和(298.5±85.7)ng/mL,和(180.6±17.1)g/L、(55.8±6.1)g/L和(685.4±164.8)ng/mL,均显著高于健康人【(22.6±6.0)g/L、(6.6±1.5)g/L和(158.7±21.5)ng/mL,P<0.05】;23例Child-PughC级患者血清IL-10水平为(84.3±11.4)g/L,显著低于31例Child-PughA级或25例Child-PughB级【分别为(121.3±14.6)g/L和(101.4±12.6)g/L;P<0.05】,而血清IL-2、IL-6和sICAM-1水平分别为(182.7±31.4)g/L、(57.3±7.3)g/L和(665.0±135.5)ng/mL,显著高于Child-PughA级或Child-PughB级【分别为(138.4±19.6)g/L、(42.4±6.6)g/L和(398.7±103.3)ng/mL,和(157.7±22.3)g/L、(49.9±6.2)g/L和(509.6±122.9)ng/mL,P<0.05】;肝硬化患者发生自发性细菌性腹膜炎、肝性脑病或消化道出血时,血清IL-10水平会进一步降低,而血清IL-2、IL-6和sICAM-1水平则进一步升高。结论乙型肝炎肝硬化患者血清细胞因子水平会随着疾病的变化而改变,了解这些变化对指导诊疗可能有帮助。
Objective To investigate the changes of serum IL-10 and soluble intercellular adhesion molecule-1(sICAM 1)levels in patients with hepatitis B-induced liver cirrhosis(LC).Methods A total of 79 patients with hepatitis B-induced LC,including 31 with Child-Pugh class A,25 with Child-Pugh class B and 23 with Child-Pugh class C,were enrolled in our hospital between September 2014 and August 2016,and 23 healthy persons were selected as control.Serum interleukin(IL)-2,IL-6,IL-10 and sICAM 1 levels were detected by enzyme-linked immunosorbent assay.Results Serum IL-10 levels in patients with compensated and decompensated LC were(43.5±8.4)g/L and(55.8±6.1)g/L,respectively,much lower than(247.1±43.4)g/L(P<0.01)in healthy persons,while serum IL-2,IL-6 and sICAM-1 levels were(148.1±21.3)g/L,(43.5±8.4)g/L and(298.5±85.7)ng/mL,and(180.6±17.1)g/L,(55.8±6.1)g/L and(685.4±164.8)ng/mL,respectively,significantly higher than(22.6±6.0)g/L,(6.6±1.5)g/L and(158.7±21.5)ng/mL in healthy control(P<0.05);serum IL-10 level in 23 patients with Child-Pugh class C was(84.3±11.4)g/L,much lower than(121.3±14.6)g/L in 31 patients with Child-Pugh class A or(101.4±12.6)g/L in 25 with Child-Pugh class B(P<0.05),while serum IL-2,IL-6 and sICAM-1 levels were(182.7±31.4)g/L,(57.3±7.3)g/L and(665.0±135.5)ng/mL,much higher than(138.4±19.6)g/L,(42.4±6.6)g/L and(398.7±103.3)ng/mL,in patients with Child-Pugh class A or(157.7±22.3)g/L,(49.9±6.2)g/L and(509.6±122.9)ng/mL in patients with Child-Pugh class B(all P<0.05);serum IL-10 levels decreased,while serum IL-2,IL-6 and sICAM-1 levels increased in patients with complications such as spontaneous bacterial peritonitis,hepatic encephalopathy or gastrointestinal bleeding.Conclusion Serum cytokine levels change as liver functions deteriorate,which might be helpful for clinicians to make managements in time in clinical practice.
作者
金军
宋震宇
刘吉祥
Jin Jun;Song Zhenyu;Liu Jixiang(Department of Gastroenterology,Central Hospital,Bazhong 636000,Sichuan Province,China)
出处
《实用肝脏病杂志》
CAS
2019年第4期549-552,共4页
Journal of Practical Hepatology
基金
四川省自然科学基金资助项目(编号:2017393)
