免疫球蛋白A肾病病人血清白细胞介素-17、白细胞介素-18表达变化与乙型肝炎病毒感染的相关性  

Correlation between serum IL-17 and IL-18 expressions and hepatitis B virus infection in patients with IgA nephropathy

作　　者：张世杰 宋晓杰 王利军 裴旭东[4] ZHANG Shijie;SONG Xiaojie;WANG Lijun;PEI Xudong(Department of Nephrology,The Second People's Hospital,Pingdingshan,Henan 467000,China;Emergency Department,The Second People's Hospital,Pingdingshan,Henan 467000,China;Intensive Care Unit,The Second People's Hospital,Pingdingshan,Henan 467000,China;Department of Infectious Liver Diseases,Nanyang Central Hospital,Nanyang,Henan 473009,China)

机构地区：[1]平顶山市第二人民医院肾病科,河南平顶山467000 [2]平顶山市第二人民医院急诊科,河南平顶山467000 [3]平顶山市第二人民医院重症监护室,河南平顶山467000 [4]南阳市中心医院感染肝病科,河南南阳473009

出　　处：《安徽医药》2022年第10期2086-2089,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨免疫球蛋白A(IgA)肾病病人血清白细胞介素-17(IL-17)、白细胞介素-18(IL-18)表达变化与乙型肝炎病毒(HBV)感染的相关性。方法选取2016年3月至2019年3月南阳市中心医院224例IgA肾病病人,其中乙型肝炎病毒感染67例作为感染组,未感染病人157例作为未感染组。另选取无肾脏疾病的单纯乙型肝炎病毒感染病人67例作为对照组。对比三组不同乙肝病毒脱氧核糖核酸(HBV-DNA)载量病人、乙肝表面抗原(HBeAg)阴性及阳性病人血清IL-17、IL-18水平,分析血清IL-17、IL-18对IgA肾病病人HBV感染的诊断价值及与HBV-DNA载量、肝功能[谷草转氨酶(AST)、谷丙转氨酶(ALT)]相关性。结果三组血清IL-17、IL-18水平对比差异有统计学意义(P<0.05),且未感染组IL-17(12.68±2.13)ng/L、IL-18(360.37±25.37)ng/L水平低于对照组[(14.78±2.69)ng/L、(412.37±30.25)ng/L](P<0.05);血清IL-17、IL-18联合诊断IgA肾病病人HBV感染的AUC高于血清IL-17、IL-18单独诊断,灵敏度为79.10%,特异度为94.90%;HBV-DNA高载量病人血清IL-17(19.21±3.12)ng/L、IL-18(547.34±40.12)ng/L水平高于低载量病人[(15.41±2.94)ng/L、(431.57±35.69)ng/L](P<0.05);血清IL-17、IL-18水平与IgA肾病伴HBV感染病人HBV-DNA载量呈正相关(P<0.05);血清IL-17、IL-18水平与IgA肾病伴HBV感染病人血清AST、ALT水平呈正相关(P<0.05)。结论IgA肾病伴HBV感染病人血清IL-17、IL-18表达异常,且异常程度与HBV-DNA载量关系密切,以上血清指标动态变化可及时反映IgA肾病病人HBV感染情况及肝功能变化。Objective To investigate the correlation between the changes in serum interleukin-17(IL-17)and interleukin-18(IL-18)expressions and hepatitis B virus(HBV)infection in patients with IgA nephropathy.Methods A total of 224 patients with IgA nephropathy,admitted to The Second People's Hospital of Pingdingshan City and Nanyang Central Hospital from March 2016 to March 2019,were enrolled in the study.Among them,67 patients infected with hepatitis B virus were chosen as the infection group,and 157 patients uninfected were taken as the uninfected group.Another 67 patients with simple hepatitis B virus infection were selected as the control group.A comparison was made of the serum IL-17 and IL-18 levels among the three groups,including patients with different HBV-DNA loads and HBeAg negative and positive patients.The diagnostic value of serum IL-17 and IL-18 for HBV infection in patients with IgA nephropathy and its correlation with HBV-DNA load and liver function[aspartate aminotransferase(AST),alanine aminotransferase(ALT)].Results The serum levels of IL-17 and IL-18 in the three groups were significantly different(P<0.05),and the levels of IL-17 and IL-18 in the uninfected group were lower than those in the control group[(12.68±2.13)ng/L vs.(14.78±2.69)ng/L,(360.37±25.37)ng/L vs.(412.37±30.25)ng/L](P<0.05).The combined AUC value of serum IL-17 and IL-18 for the diagnosis of HBV infection in patients with IgA nephropathy was higher than that of serum IL-17 and IL-18 alone.The sensitivity was 79.10%,and the specificity was 94.90%,Serum IL-17 and IL-18 levels in HBV-DNA high-load patients were higher than those in low-load patients[(19.21±3.12)ng/L vs.(15.41±2.94)ng/L,(547.34±40.12)ng/L vs.(431.57±35.69)ng/L](P<0.05).Serum IL-17 and IL-18 levels were positively correlated with HBV-DNA load in patients with IgA nephropathy and HBV infection(P<0.05).Serum IL-17 and IL-18 levels were positively correlated with serum AST and ALT levels in patients with IgA nephropathy and HBV infection(P<0.05).Conclusion IgA nephropat

关 键 词：肾小球肾炎 IGA 白细胞介素-17 白细胞介素-18 乙型肝炎病毒 

分 类 号：R512.62[医药卫生—内科学] R692[医药卫生—临床医学]