HBV相关慢加急性肝衰竭患者血清IL-32和IL-10水平变化及意义  

Changes in serum levels of interleukin-32 and interleukin-10 and their clinical significance in patients with HBV-related acute-on-chronic liver failure

作　　者：顾静[1] 王艳[1] 陈丽[1] 徐英[1] 甘建和[1] GU Jing;WANG Yan;CHEN Li;et al(Department of Infectious Diseases, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China)

机构地区：[1]苏州大学附属第一医院感染病科,江苏苏州215006

出　　处：《临床肝胆病杂志》2018年第4期801-805,共5页Journal of Clinical Hepatology

基　　金：国家科技部"十二五"重大专项(2012X10002004-008)

摘　　要：目的探讨HBV相关慢加急性肝衰竭(HBV-ACLF)患者血清IL-32和IL-10水平的变化规律及临床意义。方法选取2012年9月-2014年3月在苏州大学附属第一医院住院治疗的38例HBV-ACLF患者、20例慢性乙型肝炎(CHB)患者及20例健康对照者,采用ELISA法动态监测血清IL-32和IL-10水平变化,同时比较HBV-ACLF早中晚期、感染组与非感染组、存活组与死亡组IL-32、IL-10水平。计量资料2组间比较采用t检验,多组间比较采用方差分析,进一步2组间比较采用SNK-q检验。结果 HBV-ACLF组IL-32水平[(500.98±152.33)pg/ml]显著高于CHB组[(281.72±99.28)pg/ml]及健康对照组[(178.16±50.54)pg/ml](P值均<0.05);HBV-ACLF组IL-10水平[(4.82±1.03)pg/ml]显著高于CHB组[(3.15±0.98)pg/ml]及健康对照组[(1.62±0.43)pg/ml](P值均<0.05)。动态监测HBV-ACLF组IL-32水平显示,HBV-ACLF早期高于中期[(540.69±155.71)pg/ml vs(498.43±135.56)pg/ml,P<0.05],中期高于晚期[(498.43±135.56)pg/ml vs(450.77±102.33)pg/ml,P<0.05];比较IL-10水平,HBV-ACLF早期低于中期[(1.94±0.44)pg/ml vs(2.83±0.97)pg/ml,P<0.05],中期低于晚期[(2.83±0.97)pg/ml vs(3.69±1.23)pg/ml,P<0.05]。HBV-ACLF感染组IL-32水平高于非感染组[(553.41±158.65)pg/ml vs(482.54±110.16)pg/ml,P=0.021];HBV-ACLF存活组IL-32水平低于死亡组[(481.95±100.67)pg/ml vs(540.62±112.45)pg/ml,P=0.011],存活组IL-10高于死亡组[(4.21±1.27)pg/ml vs(3.61±1.05)pg/ml,P=0.038]。结论细胞因子网络在HBV-ACLF发病机制中发挥重要作用,血清IL-32及IL-10参与疾病的进展过程,动态监测其水平有助于判断预后。Objective To investigate the changes in the serum levels of interleukin-32（IL-32） and interleukin-10（IL-10） and their clinical significance in patients with HBV-related acute-on-chronic liver failure（HBV-ACLF）.Methods A total of 38 HBV-ACLF patients who were hospitalized and treated in The First Affiliated Hospital of Soochow University from September 2012 to March 2014 were enrolled as HBV-ACLF group,as well as 20 patients with chronic hepatitis B（CHB）（CHB group） and 20 healthy controls（healthy control group）.ELISA was used for dynamic monitoring of the changes in the serum levels of IL-32 and IL-10.The serum levels of IL-32 and IL-10 were compared between early-,middle-,and late-stage HBV-ACLF groups,between infection group and non-infection group,and between survival group and death group.The t-test was used for comparison of continuous data between two groups; an analysis of variance was used for comparison between multiple groups,and the SNK-q test was used for further comparison between two groups.Results Compared with the CHB group and the healthy control group,the HBV-ACLF group had significantly higher levels of IL-32（500.98 ± 152.33 pg/ml vs 281.72 ± 99.28 pg/ml and 178.16 ± 50.54 pg/ml,both P 〈 0.05） and IL-10（4.82 ± 1.03 pg/ml vs3.15 ± 0.98 pg/ml and 1.62 ± 0.43 pg/ml,both P 〈 0.05）.Dynamic monitoring of IL-32 level in the HBV-ACLF group showed that the early-stage HBV-ACLF group had a significantly higher level than the middle-stage HBV-ACLF group（540.69 ± 155.71 pg/ml vs 498.43 ± 135.56 pg/ml,P 〈 0.05）,and the middle-stage HBV-ACLF group had a significantly higher level than the late-stage HBV-ACLF group（498.43 ± 135.56 pg/ml vs 450.77 ± 102.33 pg/ml,P 〈 0.05）; as for the level of IL-10,the early-stage HBV-ACLF group had a significantly lower level than the middle-stage HBV-ACLF group（1.94 ± 0.44 pg/ml vs 2.83 ± 0.97 pg/ml,P 〈 0.05）,and the middle-stage HBV-ACLF group had a significantly lower level than the late-stage HBV-ACLF group�

关 键 词：肝功能衰竭 肝炎病毒 乙型 白细胞介素10 白细胞介素32 

分 类 号：R512.62[医药卫生—内科学] R575.3[医药卫生—临床医学]