自身免疫性肝炎患者血清巨噬细胞迁移抑制因子和白细胞介素-21水平变化及其对治疗应答的影响  

Serum macrophage migration inhibitory factor and interleukin-21 levels in patients with autoimmune hepatitis

作　　者：高宇[1] 杨磊[1] 胡光明 孙占虎 周涛[1] 肖杰[1] Gao Yu;Yang Lei;Hu Guangming(Department of Hepatobiliary Surgery,Qianjiang Hospital Affiliated to Chongqing University,409000,Chongqing,China)

机构地区：[1]重庆大学附属黔江医院肝胆外科,重庆市409000

出　　处：《实用肝脏病杂志》2024年第6期866-869,共4页Journal of Practical Hepatology

基　　金：重庆市自然科学基金资助项目(编号:cstc2020jcyj-bshX0068)。

摘　　要：目的探讨自身免疫性肝炎(AIH)患者血清巨噬细胞迁移抑制因子(MIF)和白细胞介素-21(IL-21)水平变化及其对治疗应答的影响。方法2017年12月~2022年11月我院诊治的AIH患者61例,均接受泼尼松联合硫唑嘌呤联合治疗。在治疗前,行肝穿刺检查,采用ELISA法检测血清MIF和IL-21水平。结果17例临床重度AIH患者血清MIF和IL-21水平分别(2.5±0.9)μg/L和(321.5±34.2)pg/mL,显著高于44例轻中度患者【分别为(1.5±0.5)μg/L和(174.7±20.5)pg/mL,P<0.05】;26例肝组织G3~G4炎症活动度患者血清MIF和IL-21水平分别(2.6±1.1)μg/L和(332.9±35.4)pg/mL,显著高于35例G1~G2患者【分别为(1.5±0.6)μg/L和(170.8±25.4)pg/mL,P<0.05】;经标准免疫抑制治疗,本组61例AIH患者生化学应答率为88.5%;9例超过6个月获得生化学应答患者血清MIF和IL-21水平分别(2.9±1.5)μg/L和(334.5±40.6)pg/mL,显著高于22例在6个月内应答患者【分别为(1.5±0.3)μg/L和(194.8±19.5)pg/mL,P<0.05】或23例在3个月内应答患者【分别为(0.9±0.2)μg/L和(100.6±9.2)pg/mL,P<0.05】。结论AIH患者血清MIF和IL-21水平升高,可能与病情重或对标准治疗应答差有关,值得进一步研究。Objective The aim of this study was to investigate implication of serum macrophage migration inhibitory factor(MIF)and interleukin-21(IL-21)level changes in patients with autoimmune hepatitis(AIH).Methods 61 consecutive patients with AIH were encountered in our hospital between December 2017 and November 2022,and all received standardized immunosuppressive therapy by prednisone and azathioprine combination.Liver biopsies were performed and serum MIF and IL-21 levels were assayed by ELISA at presentation.Results Serum MIF and IL-21 levels in 17 patients with clinically determined severe liver injury were(2.5±0.9)μg/L and(321.5±34.2)pg/mL,both much higher than[(1.5±0.5)μg/L and(174.7±20.5)pg/mL,respectively,P<0.05]in 44 patients with mild to moderate liver injury;serum MIF and IL-21 levels in 26 patients with histo-pathologicall proved G3-G4 inflammatory activity were(2.6±1.1)μg/L and(332.9±35.4)pg/mL,both much higher than[(1.5±0.6)μg/L and(170.8±25.4)pg/mL,respectively,P<0.05]in 35 patients with G1-G2 inflammatory activity;of our series,54 patients(88.5%)responded biochemically to standardized immunosuppressive therapy,and serum MIF and IL-2 levels in 19 patients responded late after six months were(2.9±1.5)μg/L and(334.5±40.6)pg/mL,significantly higher than[(1.5±0.3)μg/L and(194.8±19.5)pg/mL,respectively,P<0.05]in 22 patients who responded less than six months or[(0.9±0.2)μg/L and(100.6±9.2)pg/mL,respectively,P<0.05]in 23 patients who responded less than three months.Conclusion Serum MIF and IL-21 levels in patients with AIH elevate,which might influence liver injury and response to immunosuppressive therapy,and warrants further investigation.

关 键 词：自身免疫性肝炎 免疫抑制治疗 巨噬细胞迁移抑制因子 白细胞介素-21 治疗应答 

分 类 号：R575.1[医药卫生—消化系统]