HBV相关慢加急性肝衰竭患者血清细胞因子水平与疾病预后的关系研究

doi:10.3969/j.issn.1673-8640.2014.01.006

检验医学 ›› 2014, Vol. 29 ›› Issue (1): 26-30.DOI: 10.3969/j.issn.1673-8640.2014.01.006

• 乙型肝炎病毒感染者细胞免疫的临床监测专题 • 上一篇下一篇

HBV相关慢加急性肝衰竭患者血清细胞因子水平与疾病预后的关系研究

罗光成¹, 黄云丽², 闫惠平², 冯霞², 林芳¹, 凡瞿明¹, 张国元¹

1.川北医学院附属医院检验科, 四川南充 637000;
2.首都医科大学附属北京佑安医院感染与免疫研究中心, 北京 100069

收稿日期:2012-10-29 出版日期:2014-01-20 发布日期:2014-01-20
通讯作者: 张国元, 联系电话: 0817-2262208。
作者简介:罗光成, 男, 1985年生, 硕士, 主要从事乙型肝炎细胞免疫学研究。
基金资助:
北京市自然科学基金资助项目(7111004)

Research on the relationship between serum cytokine levels and prognosis in patients with HBV-related acute-on-chronic liver failure

LUO Guangcheng¹, HUANG Yunli², YAN Huiping², FENG Xia², LIN Fang¹, FAN Quming¹, ZHANG Guoyuan¹.

1.Department of Clinical Laboratory, Affiliated Hospital of North Sichuan Medical College, Sichuan Nanchong 637000, China; 2. Center of Infection and Immunity, Beijing You′an Hospital, Capital Medical University, Beijing 100069, China

Received:2012-10-29 Online:2014-01-20 Published:2014-01-20

摘要/Abstract

摘要：

目的观察乙型肝炎病毒(HBV)相关慢加急性肝衰竭(ACLF)患者血清细胞因子水平的变化, 探讨细胞因子在疾病预后中的作用。方法收集HBV相关ACLF患者24例(治愈者13例, 死亡者11例)、慢性乙型肝炎(CHB)患者30例和正常对照者15名, 采用 Luminex 液相芯片技术检测血清白细胞介素IL-2、IL-4、IL-6、IL-8、IL-10、粒细胞-巨噬细胞刺激因子(GM-CSF)、γ干扰素(IFN-γ)和肿瘤坏死因子α(TNF-α)等细胞因子水平, 并结合临床指标进行相关分析。结果 ACLF组IL-6、IL-8和TNF-α水平高于CHB组和对照组(P<0.01), CHB组亦高于对照组(P<0.05);ACLF死亡组IL-6、TNF-α水平和终末期肝病模型(MELD)评分明显高于治愈组(P<0.05);TNF-α、IL-6与凝血酶原活动度(PTA)之间呈明显负相关(r=－0.712, P<0.001;r=－0.521, P=0.009);TNF-α、IL-6与MELD评分之间呈明显正相关(r=0.491, P<0.015;r=0.379, P=0.048)。细胞因子与HBV DNA和乙型肝炎表面抗原(HBsAg)之间无明显相关性。结果 HBV相关ACLF患者血清中多种细胞因子明显升高, 其中IL-6和TNF-α水平随疾病严重程度的增加而增加, 检测其血清细胞因子水平有助于疾病严重程度和预后转归的判断。

关键词: 细胞因子, 白细胞介素6, 肿瘤坏死因子α, 慢加急性肝衰竭

Abstract:

Objective To observe the changes of serum cytokine levels in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure(ACLF), and investigate the role of cytokines in the prognosis of HBV-related ACLF. Methods A total of 24 HBV-related ACLF patients(13 cured cases and 11 dead cases), 30 patients with chronic hepatitis B(CHB) and 15 healthy controls were enrolled. The serum levels of interleukin(IL)-2, IL-4, IL-6, IL-8, IL-10, granulocyte-macrophage colony stimulating factor(GM-CSF), gamma interferon (IFN-γ) and tumor necrosis factor alpha(TNF-α) were detected by Luminex liquid chip technology, and the relative Results were analyzed. Results The levels of IL-6, IL-8 and TNF-α in ACLF group were higher than those in CHB group and healthy control group (P<0.01), and those in CHB group were higher than those in healthy control group (P<0.05). IL-6, TNF-α and model for end stage liver disease (MELD) score in ACLF dead group were significantly higher than those in ACLF cured group(P<0.05). The levels of TNF-α and IL-6 were negatively correlated with prothrombin activity(PTA)(r=－0.712, P<0.001; r=－0.521, P=0.009). Furthermore, the levels of TNF-α and IL-6 were positively correlated with MELD score(r=0.491, P<0.015; r=0.379, P=0.048). There was no correlation among cytokines, HBV DNA and hepatitis B surface antigen(HBsAg). Results In HBV-related ACLF patients, various serum cytokines increase significantly. Furthermore, the levels of IL-6 and TNF-α increase with the severity of disease, and they are helpful in disease progression and prognosis.

Key words: Cytokine, Interleukin 6, Tumor necrosis factor alpha, Acute-on-chronic liver failure

中图分类号:

R446.63

罗光成, 黄云丽, 闫惠平, 冯霞, 林芳, 凡瞿明, 张国元. HBV相关慢加急性肝衰竭患者血清细胞因子水平与疾病预后的关系研究[J]. 检验医学, 2014, 29(1): 26-30.

LUO Guangcheng, HUANG Yunli, YAN Huiping, FENG Xia, LIN Fang, FAN Quming, ZHANG Guoyuan.. Research on the relationship between serum cytokine levels and prognosis in patients with HBV-related acute-on-chronic liver failure[J]. , 2014, 29(1): 26-30.

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HBV相关慢加急性肝衰竭患者血清细胞因子水平与疾病预后的关系研究

Research on the relationship between serum cytokine levels and prognosis in patients with HBV-related acute-on-chronic liver failure

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