IL-18、IL-37、NLRP3及NK/DC比值在乙型肝炎相关肝硬化中的临床价值  

Clinical values of IL-18,IL-37,NLRP3 and NK/DC ratio in hepatitis B-related liver cirrhosis

作　　者：吴苏君 冀恒涛[2] 彭梦乐 WU Sujun;JI Hengtao;PENG Mengle(Department of Clinical Laboratory,Henan No.3 Provincial People's Hospital,Zhengzhou 450000,Henan,China;Department of Clinical Laboratory,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,China)

机构地区：[1]河南省直第三人民医院检验科,河南郑州450000 [2]郑州大学第二附属医院检验科,河南郑州450000

出　　处：《检验医学》2022年第6期518-523,共6页Laboratory Medicine

基　　金：河南省医学科技攻关计划联合共建项目(2018020578)。

摘　　要：目的探讨白细胞介素18(IL-18)、白细胞介素37(IL-37)、核苷酸结合寡聚化结构域样受体3(NLRP3)及自然杀伤(NK)细胞/树突状细胞(DC)比值在乙型肝炎(简称乙肝)相关肝硬化中的临床价值。方法选取乙肝相关肝硬化患者129例(乙肝相关肝硬化组,根据ChildPugh分级分为A级49例、B级47例、C级33例)、乙肝患者129例(乙肝组)、体检健康者129名(正常对照组)。据病情进展将129例乙肝相关肝硬化患者分为肝硬化组(98例)和原发性肝癌组(31例)。检测所有对象IL-18、IL-37、NLRP3及NK/DC比值。采用受试者工作特征(ROC)曲线评价IL-18、IL-37、NLRP3及NK/DC比值鉴别诊断乙肝相关肝硬化与原发性肝癌的效能。结果正常对照组、乙肝组和乙肝相关肝硬化组IL-18、IL-37水平及NLRP3相对表达量依次升高(P<0.05),NK/DC比值依次降低(P<0.05)。ChildPugh分级A级、B级和C级患者IL-18、IL-37水平及NLRP3相对表达量依次升高(P<0.05),NK/DC比值依次降低(P<0.05)。原发性肝癌组IL-18、IL-37水平及NLRP3相对表达量高于肝硬化组(P<0.05),NK/DC比值低于肝硬化组(P<0.05)。ROC曲线分析结果显示,NLRP3、IL-18、IL-37、NK/DC比值单项检测及4项指标联合检测鉴别诊断乙肝相关肝硬化与原发性肝癌的曲线下面积(AUC)分别为0.893、0.886、0.860、0.838、0.982。结论IL-18、IL-37、NLRP3及NK/DC比值与乙肝相关肝硬化的发生、发展密切相关,在乙肝相关肝硬化与原发性肝癌的鉴别诊断中有一定的临床价值。Objective To investigate interleukin-18(IL-18),interleukin-37(IL-37),nucleotide-binding oligomerization domain-like receptor 3(NLRP3)and natural killer(NK)cell/dendritic cell(DC)ratio in hepatitis B-related liver cirrhosis.Methods A total of 129 patients with hepatitis B-related liver cirrhosis(hepatitis B-related liver cirrhosis group)were enrolled,and according to the ChildPugh classification,they were classified into 49 cases of grade A,47 cases of grade B and 33 cases of grade C.Totally,129 hepatitis B patients(hepatitis B group)and 129 healthy subjects(healthy control group)were enrolled as well.According to the progress of the disease,129 patients with hepatitis B-related liver cirrhosis were classified into hepatitis B-related liver cirrhosis group(98 cases)and primary liver cancer group(31 cases).All the subjects were determined for IL-18,IL-37,NLRP3 and NK/DC ratio.Receiver operating characteristic(ROC)curve was used to evaluate the efficacy of IL-18,IL-37,NLRP3 and NK/DC ratio in the differential diagnosis of hepatitis B-related liver cirrhosis and primary liver cancer.Results The levels of IL-18,IL-37 and the relative expression of NLRP3 in healthy control group,hepatitis B group and hepatitis B-related liver cirrhosis group were increased in turn(P<0.05),and the NK/DC ratios were decreased in turn(P<0.05).The levels of IL-18,IL-37 and the relative expression of NLRP3 in ChildPugh grade A,B and C were increased in turn(P<0.05),and the NK/DC ratios were decreased in turn(P<0.05).The levels of IL-18,IL-37 and the relative expression of NLRP3 in primary liver cancer group were higher than those in hepatitis B-related liver cirrhosis group(P<0.05),and the NK/DC ratio in primary liver cancer group was lower than that in hepatitis B-related liver cirrhosis group(P<0.05).ROC curve analysis results showed that the areas under curves(AUC)of NLRP3,IL-18,IL-37,NK/DC ratio single determinations and the combined determination for the differential diagnosis of hepatitis B-related liver cirrhosis and primary liver ca

关 键 词：白细胞介素18 白细胞介素37 核苷酸结合寡聚化结构域样受体3 自然杀伤细胞/树突状细胞比值 乙型肝炎 肝硬化 原发性肝癌 

分 类 号：R446.1[医药卫生—诊断学]