乙型肝炎患者血清IL-1β、γ-IFN、HA、LN和PCⅢ在肝炎肝纤维化时水平的变化及其意义  

Changes and significance of serum IL- 1 beta,gamma- IFN,HA,LN and PC inhepatitis and hepatic fibrosis level in patients withviral hepatitis

作　　者：王传敏[1] 石庆凤[2] 汤守兵[1] 陈悦[1] 

机构地区：[1]湖北省十堰市太和医院(湖北医药学院附属医院)感染病科,湖北十堰442000 [2]山东省聊城市人民医院感染病科,山东聊城252004

出　　处：《临床和实验医学杂志》2015年第9期718-721,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨乙型性肝炎患者血清细胞因子白细胞介素-1β(IL-1β)、γ-干扰素(γ-IFN)与肝纤维化指标层黏蛋白(LN)、透明质酸(HA)、前Ⅲ胶原(PCⅢ)的水平变化及其意义。方法检测2012年5月至2014年5月收集的96例各种类型的乙型肝炎患者,其中急性肝炎组16例,慢性肝炎轻度组18例,慢性肝炎中度组21例,肝炎性肝硬化17例,慢性肝炎重度组24例。另取20例体检肝功能正常的研究对象作为对照组。观察六组对象IL-1β、γ-IFN、LN、HA、PCⅢ水平和肝功能等指标,并比较不同类型患者间各指标的差异与相关性。结果不同组别的肝炎患者IL-1β、γ-IFN、LN、HA、PCⅢ水平差异显著(P<0.05);随着肝炎病情的不断加重IL-1β、LN、HA、PCⅢ水平不断增高,γ-IFN水平不断下降(P<0.05)。不同肝炎严重程度疾病间的肝功能指标比较,急性肝炎患者的丙氨酸氨基转移酶(ALT)水平显著高于其他组研究对象(P<0.05);随着疾病程度的加重患者的总胆红素(TBIL)逐渐升高,白蛋白(ALB)、凝血酶原活动度(PTA)逐渐降低。随着肝纤维化程度的加重,患者的IL-1β、LN、HA、PCⅢ显著地升高,γ-IFN显著地降低(P<0.05)。γ-IFN与HA、PCⅢ呈显著的负相关,IL-1β与HA、PCⅢ呈显著的正相关(P<0.05),与LN相关性具有统计学意义(P>0.05)。结论细胞因子IL-1β、γ-IFN与肝损伤有良好的相关性,且与肝纤维化的形成密切相关。LN、HA、PCⅢ水平可作为反映肝纤维化的良好指标。因此,检测乙型肝炎患者血清中IL-1β、γ-IFN、LN、HA、PCⅢ水平对判断肝纤维化程度及评价临床治疗效果及预后具有重要意义。Objective To discuss on viral hepatitis of serum cytokines in patients with interleukin - 1 beta（IL - 1 beta）,interferon gamma（gamma - IFN）and liver fibrosis index of laminin（LN）,hyaluronic acid（HA）,the former collagen III（PC III）changes and its signifi-cance level. Methods From 2012 May to 2014 May,96 cases of various types of infection in our hospital in patients with viral hepatitis were col-lected in inspection department. 16 cases of acute hepatitis,chronic hepatitis group,18 patients with mild,moderate group of 24 cases of chronic hepatitis in 21 cases,17 cases of hepatitis,cirrhosis,chronic hepatitis and severe groups. Another 20 cases of normal liver function examination subjects were included as controls. IL - 1β,γ - IFN,LN,HA,PCⅢ levels and liver function and other indicators were observed in six groups, and compared different types of patients between the various indicators of differences and correlation. Results Differences between different groups of the IL - 1 hepatitis patients,beta,gamma - IFN,LN,HA,PC III levels were significantly（ P 〈 0. 05）. With the increase of the hepa-titisIL - 1 beta,LN,HA,PC III level rising,falling levels of gamma - IFN（ P 〈 0. 05）. Comparison of liver function indexes of different hepa-titis severity of disease,acute hepatitis ALT level is significantly higher than the other groups of subjects（ P 〈 0. 05）. With the aggravation of the disease in patients with TBIL increased,ALB and PTA decreased gradually. With the aggravation of liver fibrosis,in patients with IL - 1,LN, HA,PC beta III significantly increased,gamma - IFN significantly reduced（ P 〈 0. 05）. There was a significant positive correlation of gamma- IFN,IL - 1 beta and HA,PC III（ P 〈 0. 05）,statistically significant correlation with LN（ P 〉 0. 05）. Conclusion Cytokines IL - 1β,γ -IFN and liver damage have a good correlation,and is closely related to the formation of liver fibrosis. LN,HA,PCⅢ levels can be used as a good indicator of liver fibrosis.

关 键 词：乙型肝炎 肝纤维化 血清细胞因子 白细胞介素-1β γ-干扰素 层黏蛋白 透明质酸 前Ⅲ胶原 

分 类 号：R512.62[医药卫生—内科学]