乙型肝炎肝硬化患者血清中Th17相关细胞因子表达的临床意义  

Serum Th17-related cytokines in patients with hepatitis B virus-related liver cirrhosis

作　　者：汪美华[1] 章幼奕[1] 吴月平[1] 邹美银[1] 陈琳[1] 朱勇根[1] 沈娟[1] 李雪梅[1] 黄松平[1] 

机构地区：[1]南通市第三人民医院,江苏南通226006

出　　处：《中国病毒病杂志》2012年第3期211-215,共5页Chinese Journal of Viral Diseases

基　　金：南通市社会发展项目(S2010046)

摘　　要：目的探讨与Th17相关细胞因子在乙型肝炎(乙肝)肝硬化患者血清中表达的变化及相关关系。方法用流式细胞仪分别检测56例乙肝肝硬化(LC)患者[代偿性肝硬化患者26例,失代偿性肝硬化患者30例,其中合并有原发性肝癌(HCC)20例]和15例健康对照组患者外周血中与Th17分化、成熟有关以及分泌的特征性细胞因子白细胞介素(IL)-4、IL-6、干扰素γ(IFN-γ)和IL-17A;分析上述细胞因子在乙肝肝硬化患者中的变化及相关关系。应用SPSS 13.0统计软件进行统计学分析。结果血清IL-4、IFN-γ在LC、LC合并HCC、健康对照组间差异无统计学意义;LC合并HCC患者血清IL-6高于健康对照组(P=0.001);IL-17A高于LC患者(P=0.006)及健康对照组(P=0.003);血清IL-4、IFN-γ在代偿性、失代偿性肝硬化患者及健康对照组间差异无统计学意义;失代偿性肝硬化患者IL-6、IL-17A高于代偿性及健康对照组(P<0.05)。IFN-γ与IL-4呈正相关(r=0.484,P=0.000),与IL-17A也呈正相关(r=0.280,P=0.023),其他细胞因子间无明显相关性(P>0.05);IL-4预测失代偿性肝硬化ROC曲线下面积为0.581(P>0.05),IL-6为0.741(P=0.005),IL-17A为0.630(P=0.018),IFN-γ为0.572(P>0.05)。结论乙肝肝硬化患者血清中IL-4、IL-6、IFN-γ与IL-17A的相关性不强;定期检测IL-6、IL-17A对判断乙肝失代偿性肝硬化的发生有良好的预测价值。Objective To study the serum level of Th17-related cytokines in patients with hepatitis B virus（HBV）-related liver cirrhosis（LC）.MethodsPeripheral blood samples were collected from 56 HBV-related LC patients（26 compensated LC,30 decompensated LC） with 20 cases combined with primary hepatocellular carcinoma（HCC）.Fifteen healthy donors were recruited as controls.Flow cytometry was used to measure the serum levels of IL-4,IL-6,interferon（IFN） γ and IL-17A.Data analysis was done using SPSS13.0 statistics software.ResultsNo significant differences were found in serum IL-4,IFN among groups of patients combined with HCC and healthy controls,or among compensated LC,decompensated LC and healthy controls（P0.05）.The serum IL-6 level in patients combined with HCC was higher than that in healthy controls（P=0.001）.The serum IL-17A in patients combined with HCC was higher than that in non-HCC patients and healthy controls.The levels of serum IL-6 and IL-17A in patients with decompensated LC were significantly higher than that with compensated LC and controls（P0.05）.Positive correlations were found between IFN-γ and IL-4,IFN-γ and IL-17A.The Relative Operating Characteristic（ROC） curve predicting decompensated LC were 0.581 for IL-4（P0.05）,0.741 for IL-6（P=0.005）, 0.630 for IL-17A（P=0.018）,and 0.572 for IFN-γ（P0.05）.ConclusionsAmong the patients with HBV-related LC,IL-4,IL-6 and IFN-γ showed no correlation with IL-17A.IL-6,IL-17A,and may have predictive value for decompensated LC.

关 键 词：肝硬化 肝炎病毒 乙型 白细胞介素-4 白细胞介素-6 白细胞介素-17A 干扰素-Γ 

分 类 号：R512.62[医药卫生—内科学]