丙型肝炎肝硬化患者HCV基因型与血清白细胞介素17、白细胞介素6及维生素D的关系  

Analysis of association between different HCV genotypes and serum interleukin-17,interleukin-6,and vitamin D in patients with HCV-related cirrhosis

作　　者：吴勤[1] 孟繁平[1] 马雪梅[1] 金波[1] 申力军[1] 吴立兵[1] 楚金东[1] 来文辉 韩晶晶[1] 李捍卫[1] 

机构地区：[1]解放军第三〇二医院肝硬化诊疗中心,北京100039

出　　处：《临床肝胆病杂志》2015年第11期1849-1852,共4页Journal of Clinical Hepatology

基　　金：吴阶平医学基金会临床科研专项资助基金(320.6750.12337)

摘　　要：目的探讨不同HCV基因分型与丙型肝炎肝硬化患者血清中白细胞介素(IL)17、IL-6及维生素D的关系。方法选取2012年1-12月解放军第三〇二医院收治的76例丙型肝炎肝硬化患者,根据基因型不同分为1b型47例和2a型29例。采用ELISA法检测患者血清中IL-17、IL-6及维生素D水平。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验,采用Spearman分析血清中IL-17、IL-6及维生素D与基因分型的相关性。结果在Child-Pugh改良分级结果中,1b型患者中A级所占比例相对于2a型差异具有统计学意义(χ2=4.97,P<0.05);1b型患者的AFP、HCV RNA滴度、IL-17、IL-6、TNFα均高于2a型,差异均有统计学意义(t值分别为21.56、16.51、12.31、10.71、7.23,P值均<0.05),而IFNγ、25-OH-D、1,25(OH)2D低于2a型,差异均有统计学意义(t值分别为3.98、6.32、4.88,P值均<0.05);Spearman相关性分析发现,AFP、HCV RNA滴度、IL-6、IL-17与1b型、2a型基因均呈正相关(P值均<0.05),而IFNγ、TNFα和25-OH-D与1b型、2a型基因呈负相关(P值均<0.05)。结论 1b型患者血清中IL-17、IL-6、AFP及HCV RNA水平均高于2a型患者,而维生素D低于2a型患者,血清中IL-17、IL-6、25-OH-D、AFP及HCV RNA与基因分型有一定的相关性,而1,25(OH)2D则与基因分型无关。Objective To investigate the association between different hepatitis C virus （HCV） genotypes and serum interleukin - 17 （ IL - 17 ） , interleukin - 6 （ IL - 6）, and vitamin D in patients with HCV - related cirrhosis. Methods Seventy - six patients with HCV - related cirrhosis, who were admitted to 302 Hospital of PLA from January to December, 2012, were enrolled in the study, and they were divided in- to type 1 b group （n = 47） and type 2a group （n = 29） according to the genotypes. The levels of serum IL - 17, IL -6, and vitamin D were determined by enzyme -linked immunosorbent assay. Comparison between the two groups was made by t test, and Spearman correlation a- nalysis was used to investigate the association between serum IL - 17, IL - 6, and vitamin D and genotypes. Results The findings in im- proved Child - Pugh classification showed that there were significant differences in the percentage of grade A patients between type 1 b group and type 2a group （x^2 = 4. 97, P 〈 0.05 ） ; when compared with type 2a group, type 1 b group showed significantly higher lentiviral titers of alpha - fetoprotein （AFP） and HCV RNA and levels of IL - 17, IL - 6, and tumor necrosis factor - α （TNFα） （ t = 21.56, 16.51, 12. 31, 10.71, and 7.23, respectively, all P 〈 0.05 ）, but significantly lower levels of interferon - γ （ IFN-γ）, 25 （OH） D, and 1,25 （OH） 2D （ t = 3.98, 6.32, and 4.88, respectively ; all P 〈 0.05 ） ; Spearman correlation analysis showed that the lentiviral titers of AFP and HCV RNA and the levels of IL - 17 and IL - 6 were positively correlated with genotype l b and genotype 2a （ all P 〈 0.05 ） , while the levels of IFNγ, TNFa, and 25 - OH - D were negatively correlated with genotype 1 b and genotype 2a （ all P 〈 0. 05 ）. Conclusion Compared with those with genotype 2a, HCV -related cirrhosis patients with genotype 1 b have higher serum levels of IL - 17, IL -6, AFP, and HCV RNA, but a lower level of vitamin D; the results suggested that t

关 键 词：基因型 肝炎 丙型 慢性 肝硬化 白细胞介素17 白细胞介素6 维生素D 

分 类 号：R512.63[医药卫生—内科学] R575.2[医药卫生—临床医学]