酒精性肝病患者血清IL-33高水平的临床意义  

Clinical significance of increased serum IL-33 levels in patients with alcoholic liver diseases

作　　者：郝书理 张纪元[2] 黄昂[1] 张龙玉 孙颖[1] 李保森[1] 田辉[1] 邹正升[1] 

机构地区：[1]北京大学医学部教学医院/解放军第302医院非感染性肝病诊疗中心,北京市100039 [2]北京大学医学部教学医院/解放军第302医院肝病生物治疗研究中心,北京市100039

出　　处：《实用肝脏病杂志》2015年第2期156-159,共4页Journal of Practical Hepatology

基　　金：国家自然科学基金资助项目(No.81370530)

摘　　要：目的探讨血清IL-33异常升高在酒精性肝病(ALD)发病中的作用及其临床意义。方法应用ELISA法检测40例酒精性肝炎、17例重症酒精性肝炎、75例酒精性肝硬化和48例健康人血清IL-33及其可溶性受体ST2(s ST2)水平,分析血清IL-33水平与临床生化指标的相关性。结果酒精性肝炎、重症酒精性肝炎和酒精性肝硬化患者血清IL-33水平分别为(85.20±9.44)pg/ml、(68.70±8.14)pg/ml和(64.45±3.78)pg/ml,均显著高于健康人[(42.17±2.41)pg/ml,P<0.001],且酒精性肝炎患者血清IL-33水平较酒精性肝硬化患者明显升高(P<0.05),而在重症酒精性肝炎患者和酒精性肝硬化患者不同Child-Pugh分级组间差异无显著性(P>0.05);酒精性肝炎、重症酒精性肝炎和酒精性肝硬化患者血清s ST2水平分别为(96.75±11.30)pg/ml、(51.92±11.78)pg/ml和(75.82±6.81)pg/ml,均显著高于健康人[(43.97±3.01)pg/ml,P<0.001],且酒精性肝炎患者血清s ST2水平较重症酒精性肝炎或酒精性肝硬化明显升高(P<0.001或P<0.05),而酒精性肝硬化Child-Pugh A组患者较B级或C级明显升高(P均<0.001);ALD患者外周血清IL-33水平与s ST2无明显相关性,IL-33水平与淋巴细胞计数(R=0.273,P<0.01)、白蛋白(R=0.237,P<0.01)、ALT(R=0.462,P<0.001)、AST(R=0.387,P<0.001)和胆碱脂酶(R=0.225,P<0.01)水平呈显著正相关,而血清IL-33水平与中性粒细胞、总胆红素、碱性磷酸酶、总胆固醇和凝血酶原活动度水平无显著相关性。结论酒精性肝病患者血清升高的IL-33可能促进了患者免疫反应而诱导疾病的进展。Objective To explore the changes of serum IL-33 levels in patients with alcoholic liver dis-eases. Methods Serum levels of IL-33 and its soluble receptor sST2 in patients with alcoholic hepatitis（n=40）, severe alcoholic hepatitis（n=17）,alcoholic liver cirrhosis（n=75）,and healthy individuals （n=20） were measured by ELISA. IL-33 and sST2 levels in different groups were compared and the correlation between serum IL-33 levels and the regular biochemical indexes was analyzed. Results Patients with alcoholic hepatitis,severe alcoholic hep-atitis and cirrhosis had elevated serum IL-33 levels than that in the controls [（85.20±9.44） pg/ml,（68.70±8.14） pg/ml,（64.45±3.78） pg/ml vs. （42.17±2.41） pg/ml,P〈0.001 for all],while IL-33 in patients with alcoholic hepati-tis were significantly higher than that in cirrhotic patients（P〈0.05）;however,there was no statistical difference be-tween patients with severe hepatitis and cirrhosis with different Child-Pugh class;Serum sST2 in alcoholic hepati-tis,severe alcoholic hepatitis and cirrhosis group significantly elevated compared to that in the controls [（96.75± 11.30） pg/ml,（51.92 ±11.78） pg/ml,（75.82 ±6.81） pg/ml vs. （43.97 ±3.01） pg/ml,P〈0.001 for all],while serum sST2 levels in patients with alcoholic hepatitis was higher than that in patients with severe hepatitis or cirrhosis （P〈0.001 and P〈0.05,respectively）;in addition,serum sST2 in patients with alcoholic cirrhosis with Child-Pugh A class was significantly higher than those in cirrhotic patients with Child-Pugh B class or C class （P〈0.001 for both）;there was no correlation between serum IL-33 and sST2（R=0.100,P=0.180）;Serum IL-33 levels in patients with alcoholic liver disease showed positive correlation with lymphocyte counts（R=0.273,P〈0.01）,ALB（R=0.237, P〈0.01）,ALT（R=0.462,P〈0.001）,AST（R=0.387,P〈0.001）and CHE（R=0.225,P〈0.01）,while no significant correla-tion with neutrophils,TBIL,ALP,GGT,TC and PTA. Conclusion

关 键 词：酒精性肝病 白细胞介素-33 可溶性受体ST2 临床指标 

分 类 号：R575[医药卫生—消化系统]