摘要
目的探讨IL-18在慢性乙型肝炎(CHB)、肝衰竭中的意义.方法用酶联免疫吸附试验(ELISA)法检测78例CHB患者不同临床类型组血清IL-18水平,与肝功能完全正常的20例健康体检者作对照,同时检测肝功能、乙肝两对半、HBV-DNA、部分病人进行了HbsAg定量测定和PT测定.结果 78例CHB患者血清IL-18水平为(555.46±582.72)ng/mL;健康对照组IL-18水平为(259.0±99.57)ng/mL,经完全随机设计两独立样本比较的秩和检验(P<0.05),2组IL-18水平差异有统计学意义;抗病毒治疗应答组、HbeAg+CHB组、HBeAg-CHB组、肝衰竭组IL-18水平分别为(331.90±228.80)ng/mL、(428.02±244.08)ng/mL、(575.70±339.53)ng/mL、(1299.0±571.40)ng/mL,各组IL-18水平均高于对照组,差异均有统计学意义(z检验,P<0.01),4个临床类型组IL-18水平两两比较,肝衰竭组IL-18水平最高,与其余各组相比,差异均具有统计学意义;HBeAg-CHB组IL-18水平>HbeAg+CHB组>抗病毒治疗组,但差异无统计学意义(P>0.05).高、低病毒载量组IL-18水平分别为(618.64±690.46)ng/mL、(475.60±508.26)ng/mL,差异无统计学意义(P>0.05);HbsAg载量高、低组IL-18水平分别为:(846.40±1175.78)ng/mL)、(701.20±690.46)ng/mL,差异无统计学意义.炎症活动慢性HBV感染组63份病例IL-18与ALT、AST、Tbil相互关系经Spearman等级相关检验,相关系数有统计学意义(P<0.05),呈正相关,其中IL-18与Tbil呈高度正相关.IL-18与HBV-DNA相互关系经Spearman等级相关检验,相关系数无统计学意义(P>0.05).结论 IL-18参与了HBV感染后的免疫反应、肝脏损伤和修复过程;IL-18水平的异常升高可能系肝衰竭发生机制之一;(3)IL-18与肝损伤程度有关,与HBV-DNA、HbsAg载量无明显相关性.
Objective To explore the clinical significance of serum IL-18 in the treatment of chronic hepatitis B and liver failure.Methods The serum levels of IL-18 in 78 patients with different clinical types of chronic hepatitis B and 20 healthy subjects with normal liver function were measured with Enzyme-linked immunosorbent assay(ELISA).Meanwhile,the liver function,HBsAg,HBsAb,HBeAg,HBeAb,HBcAb and HBV-DNA of all subjects were measured,and HbsAg levels and PT of some patients were also measured.Results The serum levels of IL-18 in 78 patients with chronic hepatitis B were 555.46 ± 582.72 ng/mL,while in thehealthy control group,the serum levels of IL-18 were(259.0 ± 99.57)ng/mL.By rank sum test which is completely randomized design to compare two independent samples,the serum levels of IL-18 had statistically significant difference between chronic hepatitis B group and healthy control group(P<0.001).The serum levels of IL-18 in Anti-virus group,HbeAg+CHB group,HBeAg-CHB group,liver failure group were(331.90±228.80)ng/mL,(428.02±244.08)ng/mL,(575.70±339.53)ng/mL and(1299.0±571.40)ng/mL,respectively,and in each group the levels of IL-18 were higher than the healthy control group,and the difference was statistically significant(P <0.001).The serum levels of IL-18 in liver failure group were the highest in 4 clinical types of groups,and the difference was statistically significant.The serum levels of IL-18 were: HBeAg-CHB group > HbeAg+CHB group > anti-viral treatment group,but the difference was not statistically significant(P>0.05).The serum levels of IL-18 in high and low viral load groups were(618.64±690.46)ng/mL and(475.60±508.26)ng/mL,respectively,and there was no statistically significant difference(P>0.05).The serum levels of IL-18 of the load of HbsAg in the high and low groups were(846.40±1175.78)and(701.20±690.46)ng/mL,respectively,and there was no statistically significant difference(P>0.05).The relationships between IL-18 and ALT,AST,and Tbil were analyzed by Spearman rank correlation test and correlation coefficient was statistically significant(P<0.05)in 63 cases with the inflammatory activity of chronic HBV infection,indicating there was a positive correlation between IL-18 and ALT,AST,and Tbil.IL-18 is positively correlated with Tbil in a high degree.The relationship between IL-18 and HBV-DNA was tested by the Spearman rank correlation,the correlation coefficient was not statistically significant(P>0.05).Conclusions IL-18 is involved in the immune response,liver injury and reconditioning to HBV infection;IL-18 may be one of the reasons of hepatic failure;Serum levels of IL-18 are related to the degree of liver injury,and have no significant correlation with the loads of HBV-DNA and HbsAg.
出处
《昆明医学院学报》
2012年第3期57-61,75,共6页
Journal of Kunming Medical College
基金
云南省卫生科技基金资助项目(WSK2009)
