白细胞介素-26在乙型肝炎相关慢加急性肝衰竭患者中表达及临床意义  

Expression and clinical significance of IL-26 in hepatitis B virus-associated acute-on-chronic liver failure

作　　者：汪静 王琴[1] 杨凯[1] 张浩[1] 黄程荣 谢然 管世鹤[1] Wang Jing;Wang Qin;Yang Kai(Dept of Clinical Laboratory,The Second Affiliated Hospital of Anhui Medical University,Hefei 230601)

机构地区：[1]安徽医科大学第二附属医院检验科,合肥230601

出　　处：《安徽医科大学学报》2020年第4期612-617,共6页Acta Universitatis Medicinalis Anhui

基　　金：安徽省科技厅重点研究与开发研究项目(编号1804h08020236);安徽省转化医学研究院科研基金(2017zhyx11)。

摘　　要：目的探讨乙型肝炎相关慢加急性肝衰竭(HBV-ACLF)患者白细胞介素-26(IL-26)表达水平及其临床意义。方法采用酶联免疫吸附试验(ELISA)测定53例HBV-ACLF患者,53例慢性乙型肝炎(CHB)患者以及18例健康对照血清IL-26水平。统计一般资料,分析相关临床指标与IL-26的相关性,采用多因素Logistic回归分析,分析患者预后的独立危险因素,用ROC曲线和生存曲线评价IL-26判断患者预后的性能。结果HBV-ACLF患者血清IL-26水平明显高于非HBV-ACLF患者。IL-26表达水平与肌酐和活化部分凝血活酶时间呈正相关,多因素Logistic分析中发现总胆红素和IL-26为HBV-ACLF患者预后的独立危险因素。IL-26联合MELD建立预后模型(AUC:0.933)相较于单个指标具有更高的灵敏度和准确度。血清IL-26>1019.68 pg/ml对预测HBV-ACLF患者90 d死亡率具有可靠的预后准确性。结论IL-26水平在HBV-ACLF患者中明显升高,对监测HBV-ACLF患者病情及治疗预后具有重要临床意义和应用价值。Objective To investigate the expression level of Interleukin-26(IL-26) in hepatitis B virus-associated acute-on-chronic liver failure(HBV-ACLF) and its clinical significance.Methods Serum IL-26 levels were measured by enzyme-linked immunosorbent assay(ELISA) in 53 patients with HBV-ACLF, 53 patients with chronic hepatitis B(CHB) and 18 healthy controls. General data were statistically analyzed, and relevant clinical indicators were analyzed for their correlations with IL-26. Multivariate logistic regression analysis was used to assess independent risk factors for prognosis of patients. ROC curve and survival curve were used to evaluate the prognosis performance of patients. Results The level of IL-26 in HBV-ACLF patients was significantly higher than that in non-aclf patients. The expression of IL-26 was positively correlated with creatinine( CREA) and activated partial thromboplastin time( APTT). Multivariate logistic analysis showed that total bilirubin( TBIL) and IL-26 were independent risk factors. The prognostic model AUC( 0. 933) established by IL-26 combined with MELD was more sensitive and accurate than single index. Serum IL-26 > 1 019. 68 pg/ml had reliable prognostic accuracy in predicting 90-day mortality in patients with HBV-ACLF. Conclusion The level of IL-26 significantly increased in patients with HBVACLF,which has important clinical significance and application value in monitoring the condition and prognosis of patients with HBV-ACLF.

关 键 词：慢加急性肝衰竭 IL-26 乙型肝炎 预后 

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