酒精性肝硬化患者Th1／Th2型细胞因子的表达水平及临床意义  

Serum Th1 /Th2 cytokine levels and their clinical significance in patients with alcoholic liver cirrhosis

作　　者：陈卫红[1] 陈艳[2] 

机构地区：[1]中国疾病预防控制中心营养与食品安全所营养与疾病室北京100050 [2]解放军302医院肿瘤治疗与研究中心,北京100039

出　　处：《临床肝胆病杂志》2014年第7期631-635,共5页Journal of Clinical Hepatology

摘　　要：目的探讨酒精性肝硬化(ALC)患者血清Th1/Th2型细胞因子水平与肝功能的相关性以及临床意义。方法收集解放军302医院2011年4月至2012年12月收治的34例ALC住院患者,同时选取同期病毒性肝硬化(VLC)患者13例和健康人17例作为对照。采用流式微球阵列技术(CBA)法检测ALC患者血清Th1型细胞因子(TNFα、IFNγ、IL-12)和Th2型细胞因子(IL-10、IL-4、IL-6、IL-13)水平,分析其与ALC患者肝功能Child-Pugh分级、MELD评分及肝功能血清生化指标相关性。多组间比较采用Kruskal-Wallis H秩和检验,两组数据组间比较采用Mann-Whitney U检验。相关性分析采用Spearman rank检验。结果 ALC患者组Th1型细胞因子(TNFα和IFNγ)/Th2型细胞因子(IL-4、IL-10和IL-13)水平均低于健康对照组,差异有统计学意义(P<0.05),其水平随着Child-Pugh分级逐渐降低,分级之间差异无统计学意义。与VLC患者组相比,除IL-4外,ALC患者Th1/Th2型细胞因子显著升高,差异有统计学意义(P<0.05)。ALC患者TNFα、IL-10和IL-13水平与PTA呈正相关(P<0.05),与TBil和MELD分值显著负相关(P<0.05),特别是IL-10、IL-13、IL-4、TNFα、IFNγ水平与患者每日酒精摄入量呈显著负相关(P<0.05)。结论 ALC患者Th1/Th2型细胞因子表达水平显著降低,与酒精摄入量和肝功能损害相关,对ALC患者临床治疗和预后判断有一定的指导作用。Objective To investigate the relationship of serum Thl/Th2 cytokine levels with liver function and their clinical significance in patients with alcoholic liver cirrhosis （ALC）. Methods Thirty -four ALC patients, 13 patients with viral liver cirrhosis （VLC）, and 17 healthy controls were included in the study. Serum levels of Thl cytokines （tumor necrosis factor （TNF）ct, interferon （IFN）ν, and interleukin （IL） - 12） and Th2 cytokines （ IL - 10, IL - 4, IL - 6, and IL - 13 ） were measured by cytometric bead array, and their correlations with Child - Pugh classification, model of end - stage liver disease （MELD） score, and biochemical parameters of liver function were ana- lyzed. Comparison between multiple groups was made by Kruskal - Wallis H test, and comparison between two groups was made by MannWhitney U test. Correlation analysis was performed by Spearman rank test. Results The Thl （TNFct and IFNν）/Th2 （ IL - 10, IL -4, and IL - 13 ） cytokine levels in ALC group were significantly lower than those in healthy control group （ P 〈 0.05 ） , and these indices decreased nonsignificantly as the Child - Pugh class increased. Compared with VLC patients, ALC patients had significantly increased Thl/ Th2 cytokine levels except IL -4 level （P 〈0.05）. In ALC patients, TNFct, IL - 10, and IL - 13 levels were positively correlated with prothrombin time activity （ P 〈 0.05 ） but negatively correlated with total bilirubin and MELD score （ P 〈 0.05 ） ; especially, the levels of IL - 10, IL - 13, IL - 4, TNFα, and IFNν/were negatively correlated with daily alcohol consumption （ P 〈 0.05 ）. Conclusion The expression of Thl/Th2 eytokines is significantly reduced in ALC patients and is correlated with alcohol intake and liver function damage. Monitoring serum Thl/Th2 cytokine levels in ALC patients is helpful for clinical treatment and prognostic evaluation.

关 键 词：肝硬化 酒精性 细胞因子类 THL细胞 TH2细胞 

分 类 号：R575.2[医药卫生—消化系统]