非酒精性脂肪性肝炎患者血清sCD163和IL-1βmRNA水平变化及其临床意义探讨  

Clinical implications of sCD163 and IL-1βmRNA in patients with nonalcoholic steatohepatitis

作　　者：方菊梅 张万里 陈怡发 刘黎明[1] 黄庆勇 Fang Jumei;Zhang Wanli;Chen Yifa(Department of Gastroenterology,Central Hospital,Ezhou 436000,Hubei Province,China)

机构地区：[1]湖北省鄂州市中心医院消化内科,436000 [2]湖北省鄂州市中心医院肝胆外科,436000 [3]华中科技大学同济医学院附属协和医院普外科

出　　处：《实用肝脏病杂志》2020年第3期368-371,共4页Journal of Practical Hepatology

基　　金：湖北省卫生与计划生育委员会重点科研项目(编号:JX6A07)。

摘　　要：目的探讨非酒精性脂肪性肝炎(NASH)患者血清可溶性白细胞分化抗原163(sCD163)和白介素(IL)1βmRNA水平变化及其临床意义。方法2016年1月~2018年3月我院消化内科就诊的NASH患者51例和健康人51例。采用ELISA法检测血清sCD163、内脂素和脂联素水平,采用RT-PCR法检测血清IL-1βmRNA水平。结果NASH患者血糖(Glu)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)和总胆固醇(TC)水平为(6.1±1.4)mmol/L、(3.6±1.1)mmol/L、(2.9±0.4)mmol/L和(6.1±0.6)mmol/L,显著高于健康人【分别为(4.5±0.3)mmol/L、(2.5±0.9)mmol/L、(2.2±0.2)mmol/L和(4.5±0.3)mmol/L,P<0.05】;NASH患者血清sCD163、IL-1βmRNA、内脂素和脂联素水平分别为(70.7±10.4)ng/ml、(0.5±0.1)、(31.1±8.4)μg/ml和(6.8±1.3)μg/ml,与健康人【分别为(30.8±5.9)ng/ml、(0.1±0.2)、(15.9±2.6)μg/ml和(15.2±2.2)μg/ml,P<0.05】比,存在显著性差异;NASH患者血清ALT、AST和GGT水平分别为(73.5±3.9)U/L、(62.7±2.8)U/L和(108.0±4.1)U/L,显著高于健康人【分别为(33.5±3.9)U/L、(32.7±2.8)U/L和(48.0±4.1)U/L,P<0.05】。结论NASH患者除了存在肝功能指标的异常和血糖血脂代谢紊乱外,还表现为血清血清sCD163、IL-1βmRNA和内脂素水平升高,脂联素水平降低。了解这些变化特征,可能对判断肝组织损伤程度和病情具有重要的临床意义。Objective The aim of this study was to investigate the clinical implications of soluble cluster of differentiation 163(sCD163)and interleukin(IL)1βmRNA in patients with nonalcoholic steatohepatitis(NASH).Methods 51 patients with NASH and 51 healthy persons were enrolled in the Department of Gastroenterology in our hospital between January 2016 and March 2018,and serum levels of sCD163,visfatin and adiponectin were detected by ELISA,and blood IL-1βmRNA was assayed by RT-PCR.Results Blood glucose,low density lipoprotein(LDL-C),triglyceride(TG)and total cholesterol levels in patients with NASH were(6.1±1.4)mmol/L,(3.6±1.1)mmol/L,(2.9±0.4)mmol/L and(6.1±0.6)mmol/L,significantly higher than[(4.5±0.3)mmol/L,(2.5±0.9)mmol/L,(2.2±0.2)mmol/L and(4.5±0.3)mmol/L,respectively,P<0.05】in the control;serum sCD163,IL-1βmRNA,visfatin and adiponectin levels in patients with NASH were(70.7±10.4)ng/ml,(0.5±0.1),(31.1±8.4)μg/ml and(6.8±1.3)μg/ml,significantly different compared to【(30.8±5.9)ng/ml,(0.1±0.2),(15.9±2.6)μg/ml ad(15.2±2.2)μg/ml,respectively,P<0.05】in healthy persons;serum alanine aminotransferase,aspartate aminotransferase and gamma glutamyltranspeptidase levels in patients with NASH were(73.5±3.9)U/L,(62.7±2.8)U/L and(108.0±4.1)U/L,significantly higher than【(33.5±3.9)U/L,(32.7±2.8)U/L and(48.0±4.1)U/L,respectively,P<0.05】in healthy persons.Conclusion The patients with NASH have abnormal liver function tests,blood glucose and lipid metabolism imbalance,besides,they have elevatedserum sCD163,IL-1βmRNA and visfatin levels,and decreased adiponectin levels,which might hint liver injuries and poor prognosis.

关 键 词：非酒精性脂肪性肝炎 可溶性白细胞分化抗原163 白介素1βmRNA 内脂素 脂联素 

分 类 号：R575.1[医药卫生—消化系统]