急性戊型肝炎病毒感染患者血清中IL-22水平及其临床意义  

Clinical significance of serum interleukin-22 level in patients with acute HEV infection

作　　者：朱鹏[1] 朱季香[1] 何登明[1] 徐城[1] 郭世民[1] 李茂仕[1] 王宇明[1] 

机构地区：[1]第三军医大学西南医院感全军染病研究所,感染病研究重庆市重点实验室,重庆400038

出　　处：《第三军医大学学报》2014年第10期1087-1091,共5页Journal of Third Military Medical University

基　　金："十二五"国家科技重大专项(2012ZX10002004);国家自然科学基金面上项目(81270536);第三军医大学临床科研重大专项(2012XLC05)~~

摘　　要：目的探讨急性戊型肝炎病毒（hepatitis E vrius，HEV）感染患者血清IL-22水平与肝功能损害、疾病进展和转归的关系。方法回顾性筛选纳入西南医院感染科收治的2003年2月至2013年6月住院诊断为急性HEV感染患者47例，男性40例，女性7例，年龄（46．4±13．8）岁。根据感染HEV前是否有肝硬化基础分为肝硬化重叠HEV组（It=26）及单纯HEV组（n=21），根据病程中是否发生慢加急性肝衰竭（acute—on—chronic liver failure，ACLF）将肝硬化重叠HEV组分为ACLF组（n=13）及无ACLF组（n=13），同时设置健康对照组（n=15）。每3～7天收集患者外周血血清，ELISA检测各组血清IL-22、IL-6、IFN-γ水平，全自动生化仪检测生化指标，结合病情分析IL-22水平与急性HEV感染患者肝损害的关系。结果与健康对照组相比，单纯HEV组IL-22与IL-6水平升高（P〈0．01），IFN-γ水平无明显升高。与单纯HEV组相比，肝硬化重叠HEV组IL-22、IL-6水平均显著升高（P〈0．01），而IFN．叮水平无差异。ACLF组较无ACLF组IL-22、IL-6及IFN-γ水平更高（P〈0．01）。急性HEV感染患者IL-22水平与TBIL、IL-6及MELD评分水平呈正相关，与PTA呈负相关。6例急性HEV感染后发生ACLF的患者IL-22水平随ALT、AST、TBIL及PTA等指标的改善下降。结论IL-22参与急性HEV感染后肝脏炎性损伤的过程，与肝损害严重程度及病情转归相关。Objective To investigate the relationship of the serum level of interleukin-22 （IL-22） with the liver function impairment, progression and prognosis of acute hepatitis E virus （HEV） infection. Methods A total of 47 acute HEV infection patients including 26 pre-existing liver cirrhosis patients and 21 simple HEV infection patients admitted in our institute from February 2003 to June 2013 were enrolled in the study. Based on acute-on-chronic liver failure （ACLF） arose or not, the liver cirrhosis patients were divided into an ACLF group （ n = 13 ） and a non-ACLF group （ n = 13 ）. In addition, we set 15 healthy controls. Serum samples were collected every 3 to 7 days. Serum IL-22, IL-6 and IFN-γ levels were quantified by ELISA. Results Compared with the healthy controls, the IL-22 and IL-6 concentrations were significantly elevated in the patients with simple HEV infection （P≤0.001）, while IFN-γ level had no significant difference between the 2 groups. Meanwhile, higher IL-22 and IL-6 levels appeared in patients with pre-existing liver cirrhosis than those with simple HEV infection （P 〈0. 001 ）. The IL-22, IL-6 and IFN-γ levels were significantly higher in the ACLF group than in the non-ACLF group （P 〈 0. 010）. Patients with elevated IL-22 and IL-6 concentrations showed higher total bilirubin level and lower PTA index. In 6 acute HEV infection patients who concurrently suffered ACLF, the IL-22 concentration decreased as the liver function injury faded away and disease recovered. Conclusion IL-22 appears to be an important mediator of the inflammatory response in acute HEV infection. IL-22 level may be used as an indicating parameter of liver damage and prognosis.

关 键 词：肝炎病毒 戊型 肝硬化 白细胞介素-22 白细胞介素-6 

分 类 号：R392.11[医药卫生—免疫学] R446.112[医药卫生—基础医学]