血清IL-33水平与慢性乙型肝炎肝纤维化病情严重程度的相关性研究  

Correlation between serum IL-33 level and severity of liver fibrosis in patients with chronic hepatitis B

作　　者：高海丽[1] 杨道坤[1] 王宏伟[1] 梁海军[1] 王新伟[1] 王燕平[1] 陈宝鑫[1] Gao Haili;Yang Daokun;Wang Hongwei;Liang Haijun;Wang Xinwei;Wang Yanping;Chen Baoxin(Department of infectious diseases,the first affiliated hospital of Xinxiang Medical University,Weihui,Henan,453100,China.)

机构地区：[1]新乡医学院第一附属医院感染科,河南新乡453100

出　　处：《齐齐哈尔医学院学报》2022年第6期528-531,共4页Journal of Qiqihar Medical University

基　　金：河南省卫生科技攻关工程资助项目(182102311234)。

摘　　要：目的探讨慢性乙型肝炎(CHB)患者血清中IL-33水平与肝纤维化病情严重程度的关系。方法选择2017年6月—2019年12月本院感染科收治的105例CHB患者(CHB组)和40名健康体检者(对照组)作为研究对象。CHB患者肝纤维化严重程度采用Metavir评分系统分期,其中F0期、F1-F3期和F4期分别表示无肝纤维化、肝纤维化及肝硬化。检测并比较两组血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(IV-C)、透明质酸(HA)、层黏蛋白(LN)及IL-33水平的差异。分析F0期、F1-F3期和F4期血清IL-33水平的差异及血清IL-33与PCIII、IV-C、HA及LN的相关性。血清IL-33水平诊断肝纤维化及肝硬化的临床效能采用ROC曲线分析。结果与对照组相比,CHB组血清ALT[(374.15±38.27)U/L vs.(31.08±6.47)U/L,t=56.273,P<0.000]、AST[(370.09±40.28)U/L vs.(34.28±5.33)U/L,P<0.000]、TBIL[(32.28±4.16)μmol/L vs.(11.07±3.62)μmol/L,P<0.000)]、PCIII[(56.28±8.11)μg/L vs.(15.39±4.02)μg/L,P<0.000)]、IV-C[(255.41±35.68)μg/L vs.(100.28±24.19)μg/L,P<0.000)]、HA[(200.17±30.53)μg/L vs.(80.16±11.79)μg/L,P<0.000)]、LN[(274.87±22.43)μg/L vs.(159.43±16.06)μg/L,P<0.000])和IL-33[(602.14±46.57)pg/ml vs.(184.07±20.45)pg/ml,P<0.000)]水平均显著升高。F0期、F1-F3期和F4期三组血清PCIII、IV-C、HA、LN和IL-33水平相比较存在显著差异(F=34.448,F=29.115,F=18.554,F=23.367,F=42.814,均P<0.000);与F0期和F1-F3期相比,F4期血清PCIII、IV-C、HA、LN和IL-33水平显著升高,与F0期相比,F1-F3期血清PCIII、IV-C、HA、LN和IL-33水平显著升高,差异具有统计学意义(P<0.000)。相关性分析结果显示,血清IL-33水平与PCIII、IV-C和LN均呈现显著正相关性,相关系数r分别为0.412,0.357,0.371,均P<0.05,而与HA无明显相关性,相关系数r为0.145,P=0.235。ROC曲线结果显示血清IL-33水平在诊断CHB患者发生肝纤维化的AUC为0.896(95%CI:0.769-0.942),当截断值为648.59 Objective To investigate the relationship between serum IL-33 level and severity of liver fibrosis in patients with chronic hepatitis B(CHB).Methods A total of 105 patients suffered with CHB(CHB group)those were admitted to the department of infectious diseases,the first affiliated hospital of Xinxiang Medical University between June 2017 and December 2019 and 40 healthy people(control group)were collected as study objects.The severity of liver fibrosis in patients with CHB was evaluated by Metavir scores system and stage of F0,F1-F3 and F4 were represented no liver fibrosis,liver fibrosis and cirrhosis,respectively.The serum level of Alamine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),Type III precollagen(PCIII),Type IV collagen(IV-C),hyaluronic acid(HA),laminin(LN)and IL-33 were detected and compared between the two groups.The serum level of IL-33 in F0 stage,F1-F3 stage and F4 stage was also compared.The relationship between IL-33 and PCIII,IV-C,HA,LN level were analyzed by Spearman test.The clinical value of IL-33 in the diagnosis of liver fibrosis and cirrhosis in patients with CHB was analyzed by using ROC curve.Results The serum level of ALT[(374.15±38.27)vs.(31.08±6.47),t=56.273,P<0.000],AST[(370.09±40.28)vs.(34.28±5.33),t=52.441,P<0.000],TBIL[(32.28±4.16)vs.(11.07±3.62),t=28.396,P<0.0000,PCIII[(56.28±8.11)vs.(15.39±4.02),t=30.447,P<0.000],IV-C[(255.41±35.68)vs.(100.28±24.19),t=25.341,P<0.000],HA[(200.17±30.53)vs.(80.16±11.79),t=24.142,P<0.000],LN[(274.87±22.43)vs.(159.43±16.06),t=29.746,P<0.000]and IL-33[(602.14±46.57)vs.(184.07±20.45),t=54.711,P<0.000]in CHB group were significantly higher than those of control group.There were significant differences in serum levels of PCIII,IV-C,HA,LN and IL-33 among F0,F1-F3 and F4 stage(F=34.448,F=29.115,F=18.554,F=23.367,F=42.814,all P<0.000).The serum level of PCIII,IV-C,HA,LN and IL-33 in F4 stage were significantly higher than those in F0 and F1-F3 stage,and the levels of the above five indexes in F1-F3 stage were

关 键 词：慢性乙型肝炎 肝纤维化 IL-33 ROC曲线 标志物 

分 类 号：R512.62[医药卫生—内科学]