重度慢性乙型肝炎患者外周血单个核细胞中焦亡相关因子表达及与预后的关系  

Expression of pyroptosis related factors in peripheral blood mononuclear cell of patients with severe chronic hepatitis B and its relationship with prognosis

作　　者：王莲珊 马雪梅 郑成芳 Wang Lianshan;Ma Xuemei;Zheng Chengfang(Department of Infectious Diseases,Hainan West Central Hospital,Hainan Danzhou 571700,China)

机构地区：[1]海南西部中心医院感染性疾病科,海南儋州571700

出　　处：《新发传染病电子杂志》2023年第2期28-33,共6页Electronic Journal of Emerging Infectious Diseases

基　　金：2016年海南省卫生计生行业科研项目(1601032034A2003)。

摘　　要：目的探讨重度慢性乙型肝炎(CHB)患者外周血单个核细胞(PBMC)培养上清液中白细胞介素-18(IL-18)、白细胞介素-1β(IL-1β)、Nod样受体蛋白3(NLRP3)、半胱天冬氨酸蛋白酶-1(Caspase-1)表达水平,并分析其与患者预后的关系。方法选取2019年1月至2021年1月海南西部中心医院收治的251例CHB患者作为研究组,根据患者严重程度分为轻度CHB组(93例)、中度CHB组(80例)、重度CHB组(78例),根据重度CHB患者治疗6个月后是否死亡,将患者分为死亡组(11例)和存活组(67例),另选取同时期来本院体检的265例健康者作为对照组。采用酶联免疫吸附试验(ELISA)检测PBMC培养上清液中IL-18、IL-1β、NLRP3、Caspase-1表达水平;采用Kaplan-Meier法分析IL-18、IL-1β、NLRP3、Caspase-1水平与重度CHB患者预后的关系;采用多因素Logistic回归分析影响重度CHB患者预后的因素。结果研究组患者PBMC培养上清液中IL-18、IL-1β、NLRP3、Caspase-1水平[(65.86±21.32)pg/ml、(68.06±22.44)pg/ml、(241.57±104.07)pg/ml、(179.01±81.46)pg/ml]均高于对照组[(32.11±8.95)pg/ml、(25.49±7.06)pg/ml、(87.61±23.70)pg/ml、(10.33±3.29)pg/ml],差异有统计学意义(均P<0.05);轻度CHB组、中度CHB组、重度CHB组患者PBMC培养上清液中IL-18、IL-1β、NLRP3、Caspase-1水平依次升高[IL-18:(50.66±12.80)pg/ml、(70.29±19.03)pg/ml、(79.43±20.56)pg/ml,IL-1β:(51.23±13.17)pg/ml、(72.91±18.64)pg/ml、(83.15±21.78)pg/ml,NLRP3:(136.13±34.95)pg/ml、(289.61±73.08)pg/ml、(318.01±80.50)pg/ml,Caspase-1:(100.26±27.03)pg/ml、(201.30±54.15)pg/ml、(250.04±67.42)pg/ml],差异有统计学意义(均P<0.05);死亡组患者PBMC培养上清液中IL-18、IL-1β、NLRP3、Caspase-1水平[(104.40±10.36)pg/ml、(110.32±11.57)pg/ml、(367.03±32.25)pg/ml、(292.34±36.28)pg/ml]均高于存活组[(75.33±19.82)pg/ml、(78.69±21.39)pg/ml、(309.96±71.19)pg/ml、(241.10±61.44)pg/ml],差异有统计学意义(均P<0.05);Kaplan-Meier结果显示,IL-18、IL-1β、NLRP3Objective To investigate the expression levels of interleukin-18(IL-18),interleukin-1β(IL-1β),nod-like receptor protein 3(NLRP3),cysteinyl aspartate specific proteinase(Caspase)-1 in the supernatant of peripheral blood mononuclear cells(PBMC)of patients with severe chronic hepatitis B(CHB),and analyze their relationship with the prognosis of patients.Method A total of 251 CHB patients admitted in Hainan West Central Hospital from January 2019 to January 2021 were gathered as the research group.According to the severity of patients,they were divided into mild CHB group(93 cases),moderate CHB group(80 cases),and severe CHB group(78 cases).According to whether severe CHB patients died after 6 months of treatment,the patients were divided into a death group(11 cases)and a survival group(67 cases).In addition,265 healthy people who came to our hospital for physical examination during the same period were selected as the control group.Enzyme-linked immunosorbent assay(ELISA method)was used to detect the expression levels of IL-18,IL-1β,NLRP3 and Caspase-1 in the supernatant of PBMC culture;Kaplan-Meier method was used to analyze the relationship between the levels of IL-18,IL-1β,NLRP3,Caspase-1 and the prognosis of patients with severe CHB;multivariate Logistic regression was used to analyze the factors influencing the prognosis of patients with severe CHB.Result The levels of IL-18,IL-1β,NLRP3 and Caspase-1[(65.86±21.32)pg/ml,(68.06±22.44)pg/ml,(241.57±104.07)pg/ml,(179.01±81.46)pg/ml]in the PBMC culture supernatant of the study group were higher than those in the control group[(32.11±8.95)pg/ml,(25.49±7.06)pg/ml,(87.61±23.70)pg/ml,(10.33±3.29)pg/ml],with statistically significant differences(all P<0.05);the levels of IL-18,IL-1β,NLRP3 and Caspase-1 in the PBMC culture supernatant of patients in mild CHB group,moderate CHB group and severe CHB group increased in turn[IL-18:(50.66±12.80)pg/ml,(70.29±19.03)pg/ml,(79.43±20.56)pg/ml,IL-1β:(51.23±13.17)pg/ml,(72.91±18.64)pg/ml,(83.15±21.78)pg/ml,NLRP3:

关 键 词：慢性乙型肝炎 外周血单个核细胞 焦亡 预后 

分 类 号：R512.62[医药卫生—内科学]