摘要
目的观察乙型肝炎病毒(HBV)相关慢加急性肝衰竭(ACLF)患者血清细胞因子水平的变化,探讨细胞因子在疾病预后中的作用。方法收集HBV相关ACLF患者24例(治愈者13例,死亡者11例)、慢性乙型肝炎(CHB)患者30例和正常对照者15名,采用Luminex液相芯片技术检测血清白细胞介素IL-2、IL-4、IL-6、IL-8、IL-10、粒细胞-巨噬细胞刺激因子(GM-CSF)、γ干扰素(IFN-γ)和肿瘤坏死因子α(TNF-α)等细胞因子水平,并结合临床指标进行相关分析。结果 ACLF组IL-6、IL-8和TNF-α水平高于CHB组和对照组(P<0.01),CHB组亦高于对照组(P<0.05);ACLF死亡组IL-6、TNF-α水平和终末期肝病模型(MELD)评分明显高于治愈组(P<0.05);TNF-α、IL-6与凝血酶原活动度(PTA)之间呈明显负相关(r=-0.712,P<0.001;r=-0.521,P=0.009);TNF-α、IL-6与MELD评分之间呈明显正相关(r=0.491,P<0.015;r=0.379,P=0.048)。细胞因子与HBV DNA和乙型肝炎表面抗原(HBsAg)之间无明显相关性。结论 HBV相关ACLF患者血清中多种细胞因子明显升高,其中IL-6和TNF-α水平随疾病严重程度的增加而增加,检测其血清细胞因子水平有助于疾病严重程度和预后转归的判断。
Objective To observe the changes of serum cytokine levels in patients with hepatitis B virus （HBV） - related acute-on-chronic liver failure （ ACLF ） , and investigate the role of cytokines in the prognosis of HBV-related ACLF. Methods A total of 24 HBV-related ACLF patients （13 cured cases and 11 dead cases）, 30 patients with chronic hepatitis B（CHB） and 15 healthy controls were enrolled. The serum levels of interleukin（ IL）-2, IL-4, IL-6, IL-8, IL-10, granulocyte-macrophage colony stimulating factor （GM-CSF） , gamma interferon （IFN-γ） and tumor necrosis factor alpha（TNF-α） were detected by Luminex liquid chip technology, and the relative results were analyzed. Results The levels of IL-6, IL-8 and TNF-α in ACLF group were higher than those in CHB group and healthy control group （ P 〈 0.01 ）, and those in CHB group were higher than those in healthy control group （ P 〈 0.05 ）. IL-6, TNF-α and model for end stage liver disease （MELD） score in ACLF dead group were significantly higher than those in ACLF cured group（ P 〈0.05）. The levels of TNF-α and IL-6 were negatively correlated with prothrombin activity（PTA） （r = -0. 712, P 〈0. 001 ; r = -0. 521, P =0. 009）. Furthermore, the levels of TNF-α and IL-6 were positively correlated with MELD score（r =0. 491, P 〈 0. 015 ; r = 0. 379, P = 0. 048 ）. There was no correlation among eytokines, HBV DNA and hepatitis B surface antigen（HBsAg）. Conclusions In HBV-related ACLF patients, various serum eytokines increase significantly. Furthermore, the levels of IL-6 and TNF-α increase with the severity of disease, and they are helpful in disease progression and prognosis.
出处
《检验医学》
CAS
2014年第1期26-30,共5页
Laboratory Medicine
基金
北京市自然科学基金资助项目(7111004)
