白细胞介素-22在慢加急性肝功能衰竭患者血浆l中的表达及其与预后的关系  

Expression of interleukin-22 may predict severity and outcome of patients with acute-on-chronic liver failure

作　　者：莫瑞东[1] 王芃[1] 项晓刚[1] 赖荣陶[1] 刘昱含[1] 韩艳[1] 蔡伟[1] 王晖[1] 郭清[1] 俞红[1] 谢青[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院感染科,200025

出　　处：《中华传染病杂志》2014年第12期724-728,共5页Chinese Journal of Infectious Diseases

基　　金：国家自然科学基金资助项目（81171569）;上海市科委优秀学术带头人项目（12XDl403600）;国家十二五科技重大专项项目（2012ZXl0002007-002-004、20i2ZXl0002004-003）;上海市领军人才资助项目;天晴肝病研究基金（TQGB20llOl4）;上海高校青年教师培养资助计划（Z~dyxl2020）;国家自然科学基金青年项目（81300316）;国家l临床重点专科建设项目（感染病学）

摘　　要：目的探讨IL-22在慢加急性肝功能衰竭（ACLF）患者血浆中的表达及其与预后的关系。方法前瞻性收集在上海交通大学医学院附属瑞金医院感染科住院的ACLF患者79例和健康志愿者24名。ELISA法检测患者入院时和入院28d的血浆IL-22水平，在住院第28天评估病情，患者随访至入院后5个月。根据预后分析血浆IL-22水平在ACLF病程中的动态变化并评价其预后价值。两组比较采用非配对t检验，相关性分析采用Spearman检验。结果ACLF患者血浆IL-22基线水平为（32．9士17．8）pg／mL，显著高于健康对照的（15．1±8．5）pg／mL（t=4．724，P〈0．01）。未存活组血浆IL-22基线水平为（35．2±20．2）pg／mL，明显高于存活组的34，P=0．（30．9±10．2）pg／mL（t=2．202，P=0．031），且至第28天时仍维持在高水平的（36．8±18．2）pg／mL（t=0．3739）；而存活组则降至（26．2±6．6）pg／mL（t=2．063，P=0．044）。终末期肝病模型（MELD）评分〉26分患者血浆IL-22水平为（40．1±6．8）pg／mL，高于≤20分患者的（29．2±1．4）pg／mL（t=2．131，P=0．040）。随访至5个月，IL-22≥30．5pg／mL组患者的生存时间较IL-22〈30．5pg／mL组明显下降（58d比111d，x2=3．997，P=0．046）。结论IL-22在ACLF患者血浆中表达明显升高，且其水平与患者预后和疾病转归相关，提示血浆IL-22水平有望作为判断ACLF患者预后和疾病转归的预测因子。Objective To investigate plasma interleukin-22 （IL-22） expression in patients with acute-on-chronic liver failure （ACLF） and the correlation with the disease prognosis. Methods Plasma was obtained from 79 cases of ACLF in the Department of Infectious Diseases at Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine. Plasma from 24 healthy donors was also collected as control. Plasma IL-22 levels in 79 ACLF patients at hospital admission and 28-day follow-up were measured by enzyme-linked immunosorbent assay （ELISA） method. The diseases severity was evaluated at day 28. In addition, all these ACLF patients were followed up till 5 months after their admission of hospital. Plasma IL-22 levels were measured dynamically to evaluate its role in predicting the disease prognosis. Difference between two groups was determined by unpaired t test. Spearman correlation test was used for correlation analysis. Results The baseline IL-22 levels of plasma in ACLF patients were elevated significantly compared with that of healthy controls （[-32.9±17.8] pg/mL vs [15.1 ± 8.5] pg/mL t=4. 724,P〈0.01）. The baseline plasma IL-22 levels in non-survival patients were higher than that of survival patients （[-35.2±20.2] pg/mL vs 30.9±10.2] pg/mL;t=2. 202,P=0. 031）, and stayed at a high level at 28-day follow-up （[36.8±18.2] pg/mL t=0. 334, P=0. 739）. Moreover, plasma IL-22 levels in survival patients had a significant decreasing trend during at 28-day follow-up compared to baseline level （[26.2±6.6] pg/mL t=2. 063, P=0. 044）. The plasma IL-22 levels in model for end- stage liver disease （MELD） score〉26 group （[40.1 ± 6.8] pg/mL） were markedly increased than that of MELD score〈20 group （[29. 2 ± 1. 4] pg/mL, t= 2. 131, P= 0. 040）. Five-month overall survival probability of patients with elevated plasma IL-22 levels （above the cut-off value of 30. 5 pg/mL） was significantly reduced compared to that of patients with lower plasma IL-22 levels （below the cut-off

关 键 词：白细胞介素22 肝炎 乙型 慢性 慢加急性肝衰竭 预后 

分 类 号：R575.3[医药卫生—消化系统]