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血清细胞因子在急性甲型肝炎患儿中的表达及临床意义
Expression and significance of cytokines in children with acute hepatitis A
文章发布日期:2019年08月19日  来源:  作者:韦新焕,柳雅立,张晶,等  点击次数:120次  下载次数:17次

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【摘要】:目的了解细胞因子在急性甲型肝炎患儿中的临床意义。方法观察2014年9月-2015年1月在新疆和田地区传染病专科医院住院的甲型肝炎患儿,以年龄和性别匹配的健康儿童作为对照组,检测其血清细胞因子水平,包括IL-6、IL-8、IL-10、IL-1β、TNFα,并对肝功能、凝血功能、是否合并腹水等临床指标进行监测,比较血清细胞因子与临床特征之间的关系。正态分布的计量资料2组间比较用两独立样本t检验;非正态分布的计量资料2组间比较采用Mann-Whitney U检验。计数资料2组间比较采用χ2检验。相关性比较采用Spearman秩相关分析。结果共纳入急性甲型肝炎患儿70例,健康对照组30例,血清检测发现急性甲型肝炎组患儿血清IL-10水平为19.60(15.50~32.08)pg/ml,明显高于正常对照组的5.00 (5.00~10.30)pg/ml(Z=-679,P<0.01)。急性甲型肝炎患儿血清IL-10水平与ALT(r=0.24,P=0.04)、TBil(r=0.32,P<0.01)、PT(r=0.29,P=0.01)呈正相关。此外,血清IL-10水平在黄疸型肝炎组患儿为23.20(18.04~45.00)pg/ml,而非黄疸型肝炎组患儿为18.40(14.84~24.80)pg/ml,两者之间差异具有统计学意义(Z=-2.30,P=0.02)。血清IL-10水平在合并腹水组明显高于无腹水组[42.60(19.15~7335)pg/ml vs 19.02(15.13~27.33)pg/ml,Z=-2.42,P=0.02)。血清IL-6(Z=-0.95, P=0.34)、IL-8(Z=-0.97, P=033)、IL-1β(Z=-1.33, P=0.18)、TNFα(Z=-0.34, P=0.73)在急性甲型肝炎组和健康对照组间差异均无统计学意义,且在是否黄疸型肝炎、是否合并腹水组间比较,差异亦无统计学意义(P值均>0.05)。结论血清IL-10在急性甲型肝炎患儿中明显升高,且在病情偏重的黄疸型肝炎组和合并腹水组中明显升高,提示细胞因子IL-10在急性HAV感染所致的免疫损伤中发挥主要作用。
【Abstract】:ObjectiveTo investigate the clinical significance of cytokines in children with acute hepatitis A. MethodsThe children with acute hepatitis A who were hospitalized in the Specialized Hospital of Infectious Diseases in Hotan, Xinjiang, from September 2014 to January 2015 were enrolled as acute hepatitis A group, and healthy children matched for age and sex were enrolled as control group. The serum levels of related inflammatory cytokines were measured, including interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10(IL-10), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNFα). Clinical indices such as liver function, coagulation function, and presence or absence of ascites were monitored, and the correlation between the serum cytokines and clinical features was analyzed. The two-independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups. The chi-square test was used for comparison of categorical data between two groups. A Spearman correlation analysis was used to investigate correlation. ResultsA total of 70 children with acute hepatitis A and 30 healthy children were enrolled. The serological test showed that the acute hepatitis A group had a significantly higher serum level of IL-10 than the control group [19.60 (15.50-32.08) pg/ml vs 5.00 (5.00-10.30) pg/ml, Z=-6.79, P<0.01]. In the children with acute hepatitis A, the serum level of IL-10 was positively correlated with alanine aminotransferase (r=0.24, P=0.04), total bilirubin (r=0.32, P<0.01), and prothrombin time (r=0.29, P=0.01). In addition, the serum level of IL-10 was 23.20 (18.04-45.00) pg/ml in children with jaundice hepatitis and 18.40 (14.84-24.80) pg/ml in those with non-jaundice hepatitis, and there was no significant difference between the two groups of children (Z=-2.30, P=0.02). The children with ascites had a significantly higher serum level of IL-10 than those without ascites [42.60 (19.15-73.35) pg/ml vs 19.02 (15.13-27.33) pg/ml, Z=-2.42, P=0.02]. There were no significant differences between the acute hepatitis A group and the control group in the serum levels of IL-6 (Z=-0.95, P=0.34), IL-8 (Z=-0.97, P=0.33), IL-1β (Z=-1.33, P=0.18), and TNFα (Z=-034, P=0.73), and there were also no significant differences in these cytokines between the children with jaundice hepatitis and those with non-jaundice hepatitis, as well as between the children with ascites and those without ascites (all P>0.05). ConclusionThere is a significant increase in the serum level of IL-10 in children with acute hepatitis A, especially in those with jaundice hepatitis or ascites, suggesting that IL-10 plays an important role in immunologic injury induced by acute hepatitis A virus infection.
【关键字】:甲型肝炎; 细胞因子类; 白细胞介素10; 儿童
【Key words】:hepatitis A; cytokines; interleukin-10; child
【引证本文】:WEI XH, LIU YL, ZHANG J, et al. Expression and significance of cytokines in children with acute hepatitis A[J]. J Clin Hepatol, 2019, 35(9): 1942-1945. (in Chinese)
韦新焕, 柳雅立, 张晶, 等. 血清细胞因子在急性甲型肝炎患儿中的表达及临床意义[J]. 临床肝胆病杂志, 2019, 35(9): 1942-1945.

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