白细胞介素-17A表达水平与HBV相关肝病的相关性分析  

The correlation between serum interleukin-17A and hepatitis B virus related liver diseases

作　　者：汪美华[1] 章幼奕[1] 吴月平[1] 邹美银[1] 朱勇根[1] 陈萍[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感染科,南通市226006

出　　处：《中华实验和临床感染病杂志（电子版）》2012年第3期45-48,59,共5页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：南通市社会发展项目(No.S2010046)

摘　　要：目的探讨不同类型的乙型肝炎病毒(HBV)相关性肝病患者外周血中白细胞介素(IL)-17A的表达及其与HBV相关肝病的关系。方法应用流式细胞术检测93例HBV相关肝病患者(慢性肝炎21例,肝硬化21例,肝衰竭23例,原发性肝癌28例)和15例健康对照者外周血中IL-17A;分析IL-17A在不同类型HBV相关性肝病中的变化及其与ALT、AST、TBil、ALB、PT、HBsAg、HBeAg、HBV DNA等指标的相关性;分析IL-17A对患者预后的预测价值。结果肝癌患者血清中IL-17A水平显著高于慢性肝炎、肝硬化、肝衰竭及健康对照组(P<0.05);肝衰竭组IL-17A水平显著高于肝硬化和健康对照组(P=0.000);轻、中、重慢性肝炎患者血清中IL-17A水平差异无统计学意义。失代偿期肝硬化组IL-17A水平显著高于代偿期肝硬化组(P=0.000);死亡患者血清IL-17A显著高于病情好转患者(P=0.036)。IL-17A对死亡预测的C-statistic值为0.726;IL-17A与AST、TBil呈正相关;与ALT、PT、ALB无显著相关性;与HBsAg呈负相关,与HBeAg呈正相关;而与HBV DNA无显著相关性。结论 IL-17A在肝衰竭、失代偿期肝硬化、肝癌患者中显著升高,与相关反映炎症程度的指标及HBsAg、HBeAg存在相关性。IL-17A可作为反映HBV相关性肝脏炎症损伤程度的指标之一,可预测患者的预后。Objective To investigate the expression of serum interlenkin-17A （IL-17A） in hepatitis B virus （HBV） related liver diseases and explore the relationship between IL-17A and HBV related liver diseases. Methods Peripheral blood was collected from 93 patients with HBV related liver diseases, including 21 cases of chronic hepatitis （CH）, 21 cases of liver cirrhosis （LC）, 23 cases of liver failure （LF）, 28 eases of primary hepatocyte cancer （HCC）. Total of 15 healthy persons were recruited as controls. The levels of IL-17A were detected by flow eytometry. Changes of IL-17A in different HBV related liver diseases, the correlations between IL-17A and ALT, AST, TBil, ALB, PT, HBsAg, HBeAg, HBV DNA and the predictive value of IL-17A for prognosis were analyzed, respectively. Results The level of IL-17A in HCC was significantly higher than that in CH, LC, LF and controls groups（P 〈 0.01 ）. The level of IL-17A in LF was significantly higher than that in LC and controls （P = 0. 000）. There was no significant difference among mild, middle or severe CH; IL-17A in decompensated LC was higher than that in compensated LC group（P = 0. 000）. In addition, the deaths＇ IL-17A was significantly higher than that in improved patients＇ （ P = 0. 036）. The area of ROC for death predication was 0. 726. Positive correlations were found between IL-17A and AST, TBil, HBeAg, respectively. Negative correlation was found between IL-17A and HBsAg. No correlation was found between IL-17A and ALT, PT, HBV DNA. Conclusions The levels of serum IL-17A in HBV related LF, decompensated LC, HCC increased significantly. It was correlated with some other markers of inflammation, HBsAg and HBeAg. Hence, IL-17A could become one kind of marker reflexing inflammation and injury of liver in HBV related liver diseases, which may be used to predict the prognosis of patients.

关 键 词：肝脏疾病 肝炎病毒 乙型 IL-17A 

分 类 号：R512.6[医药卫生—内科学]