药物性肝损伤患者血清IL-6、TNF-α、IL-10水平与肝损伤程度的关系  

Relationship between serum IL-6,TNF alpha,IL-10 levels and the severity of Drug-induced liver injury in patients

作　　者：李兰亚[1] 屠涛 孙志堂 LI Lan-ya;TU Tao;SUN Zhi-tang(Department of Laboratory,Shuyang County Traditional Chinese Medicine Hospital,Jiangsu 223600,China;Department of Hepatology,Shuyang County Traditional Chinese Medicine Hospital,Jiangsu 223600,China)

机构地区：[1]沭阳县中医院检验科,江苏223600 [2]沭阳县中医院肝病科,江苏223600

出　　处：《肝脏》2024年第5期557-560,587,共5页Chinese Hepatology

基　　金：江苏省自然科学基金青年基金项目(BK20190189)。

摘　　要：目的分析药物性肝损伤患者血清白介素6(IL-6)、肿瘤坏死因子-α(TNF-α)、白介素10(IL-10)水平与肝损伤程度的关系。方法2021年6月—2023年6月在沭阳县中医院进行治疗的96例药物性肝损伤患者设为观察组,依据其肝功能损伤程度分为轻度肝损伤48例,中度肝损伤37例,重度肝损伤11例。另选同期于我院体检中心体检的84名肝功能正常人群设为健康组。比较两组血清IL-6、TNF-α、IL-10水平,比较不同程度肝损伤患者引发药物性肝损伤的药物种类,比较不同程度肝损伤患者IL-6、TNF-α、IL-10水平,对所有肝损伤患者给予护肝等对症治疗,比较治疗后不同程度肝损伤患者IL-6、TNF-α、IL-10水平,采用斯皮尔曼(Spearman)秩相关分析血清IL-6、TNF-α、IL-10水平与肝损伤程度的相关性。结果观察组IL-6、TNF-α水平[(29.8±6.4)pg/mL、(13.6±3.5)pg/mL]均高于健康组[(12.4±3.7)pg/mL、(3.8±1.3)pg/mL],IL-10(1.3±0.4)pg/mL低于健康组(4.9±0.8)pg/mL(P<0.05);不同程度肝损伤患者引发药物性肝损伤的药物种类比较差异无统计学意义(P>0.05);重度肝损伤组IL-6、TNF-α[(37.6±10.5)pg/mL、(23.1±5.6)pg/mL]水平高于中度肝损伤组[(31.5±8.1)pg/mL、(15.9±3.4)pg/mL],IL-10(1.1±0.3)pg/mL低于中度肝损伤组(1.6±0.6)pg/mL,中度肝损伤组IL-6、TNF-α水平高于轻度肝损伤组[(26.6±3.7)pg/mL、(11.3±1.1)pg/mL],IL-10低于轻度肝损伤组(2.7±0.6)pg/mL(P<0.05);治疗后重度肝损伤组IL-6、TNF-α[(23.5±3.7)pg/mL、(8.9±3.6)pg/mL]水平高于中度肝损伤组[(19.4±3.5)pg/mL、(6.2±1.4)pg/mL],IL-10(2.9±0.9)pg/mL低于中度肝损伤组(3.7±0.8)pg/mL,中度肝损伤组IL-6、TNF-α水平高于轻度肝损伤组[(16.5±2.9)pg/mL、(4.7±1.2)pg/mL],IL-10低于轻度肝损伤组(4.2±1.1)pg/mL(P<0.05);相关性分析显示,血清IL-6、TNF-α水平与药物性肝损伤患者的肝损伤严重程度呈正相关,IL-10水平与其呈负相关(r=0.753、0.814、-0.792,P<0.05)。结论血清IL-6、TNFObjective To explore the levels of serum interleukin 6(IL-6),tumor necrosis factor-alpha(TNF-α),interleukin-10(IL-10)and their correlation with the severity of drug-induced liver injury(DILI).Methods Between June 2021 and June 2023,a total of 96 patients treated for DILI at our hospital were designated as the observation group.This group was stratified into 48 cases with mild liver injury,37 with moderate liver injury,and 11 with severe liver injury based on the extent of liver function impairment.Additionally,84 individuals with normal liver function,who underwent physical examinations at our hospital’s examination center during the same period,selected as the healthy control group.We conducted comparisons of serum IL-6,TNF-αand IL-10 levels between the DILI patients and the healthy group.The analysis also included comparisons of these cytokine levels among DILI patients with varing degrees of liver injury both before and after receiving symptomatic treatments,such as liver protection measures.Furthermore,the types of drugs responsible of liver injury in patients were compared across different severity levels.To determine the correlation between cytokine levels and the severity of liver injury,Spearman rank correlation analysis was utilized.This comprehensive approach allowed for a detailed examination of the relationship between inflammatory markers and liver injury severity in patients experiencing DILI.Results In the Observation group of 96 patients with DILI,levels of IL-6 and TNF-αwere significantly higher compared to the healthy control group:IL-6 at[(29.8±6.4)pg/mL and TNF-αat(13.6±3.5)pg/mL)versus(12.4±3.7)pg/ml and(3.8±1.3)pg/mL,respectively,in the control group.Conversely,IL-10 levels were lower in the DILI group[(1.3±0.4)pg/mL]compared to the healthy group[(4.9±0.8)pg/mL],with statistical significance(P<0.05).The analysis revealed no significant difference in the classes of drugs causing liver injury among patients with varying degrees of drug-induced liver injury(P>0.05).In severe liver i

关 键 词：药物性肝损伤 白介素6 肿瘤坏死因子-Α 白介素10 肝损伤程度 

分 类 号：R575[医药卫生—消化系统]