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HBV相关慢加急性肝衰竭患者血清IL-32和IL-10水平变化及意义
Changes in serum levels of interleukin-32 and interleukin-10 and their clinical significance in patients with HBV-related acute-on-chronic liver failure
文章发布日期:2018年03月07日  来源:  作者:顾静,王艳,陈丽,等  点击次数:780次  下载次数:111次

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【摘要】:目的探讨HBV相关慢加急性肝衰竭(HBV-ACLF)患者血清IL-32和IL-10水平的变化规律及临床意义。方法选取2012年9月-2014年3月在苏州大学附属第一医院住院治疗的38例HBV-ACLF患者、20例慢性乙型肝炎(CHB)患者及20例健康对照者,采用ELISA法动态监测血清IL-32和IL-10水平变化,同时比较HBV-ACLF早中晚期、感染组与非感染组、存活组与死亡组IL-32、IL-10水平。计量资料2组间比较采用t检验,多组间比较采用方差分析,进一步2组间比较采用SNK-q检验。结果HBV-ACLF组IL-32水平[(500.98±152.33)pg/ml]显著高于CHB组[(281.72±99.28)pg/ml]及健康对照组[(178.16±50.54)pg/ml](P值均<0.05);HBV-ACLF组IL-10水平[(4.82±1.03)pg/ml]显著高于CHB组[(3.15±0.98)pg/ml]及健康对照组[(1.62±0.43)pg/ml](P值均<0.05)。动态监测HBV-ACLF组IL-32水平显示,HBV-ACLF早期高于中期[(54069±155.71)pg/ml vs (498.43±135.56)pg/ml,P<0.05],中期高于晚期[(498.43±135.56) pg/ml vs (450.77±10233) pg/ml,P<0.05];比较IL-10水平,HBV-ACLF早期低于中期[(1.94±0.44) pg/ml vs (2.83±0.97) pg/ml,P<0.05],中期低于晚期[(2.83±0.97)pg/ml vs (3.69±1.23)pg/ml,P<0.05]。HBV-ACLF感染组IL-32水平高于非感染组[(553.41±158.65)pg/ml vs (482.54±110.16)pg/ml,P=0.021];HBV-ACLF存活组IL-32水平低于死亡组[(481.95±100.67)pg/ml vs (540.62±112.45)pg/ml,P=0.011],存活组IL-10高于死亡组[(4.21±1.27)pg/ml vs (3.61±1.05) pg/ml,P=0.038]。结论细胞因子网络在HBV-ACLF发病机制中发挥重要作用,血清IL-32及IL-10参与疾病的进展过程,动态监测其水平有助于判断预后。
【Abstract】:ObjectiveTo investigate the changes in the serum levels of interleukin-32 (IL-32) and interleukin-10 (IL-10) and their clinical significance in patients with HBV-related acute-on-chronic liver failure (HBV-ACLF). MethodsA total of 38 HBV-ACLF patients who were hospitalized and treated in The First Affiliated Hospital of Soochow University from September 2012 to March 2014 were enrolled as HBV-ACLF group, as well as 20 patients with chronic hepatitis B (CHB) (CHB group) and 20 healthy controls (healthy control group). ELISA was used for dynamic monitoring of the changes in the serum levels of IL-32 and IL-10. The serum levels of IL-32 and IL-10 were compared between early-, middle-, and late-stage HBV-ACLF groups, between infection group and non-infection group, and between survival group and death group. The t-test was used for comparison of continuous data between two groups; an analysis of variance was used for comparison between multiple groups, and the SNK-q test was used for further comparison between two groups. ResultsCompared with the CHB group and the healthy control group, the HBV-ACLF group had significantly higher levels of IL-32 (50098±152.33 pg/ml vs 281.72±99.28 pg/ml and 178.16±50.54 pg/ml, both P<0.05) and IL-10 (4.82±1.03 pg/ml vs 3.15±0.98 pg/ml and 1.62±0.43 pg/ml, both P<0.05). Dynamic monitoring of IL-32 level in the HBV-ACLF group showed that the early-stage HBV-ACLF group had a significantly higher level than the middle-stage HBV-ACLF group (540.69±155.71 pg/ml vs 498.43±135.56 pg/ml, P<0.05), and the middle-stage HBV-ACLF group had a significantly higher level than the late-stage HBV-ACLF group (498.43±135.56 pg/ml vs 450.77±102.33 pg/ml, P<0.05); as for the level of IL-10, the early-stage HBV-ACLF group had a significantly lower level than the middle-stage HBV-ACLF group (1.94±0.44 pg/ml vs 2.83±0.97 pg/ml, P<0.05), and the middle-stage HBV-ACLF group had a significantly lower level than the late-stage HBV-ACLF group (2.83±0.97 pg/ml vs 3.69±123 pg/ml, P<0.05). The HBV-ACLF infection group had a significantly higher level of IL-32 than the non-infection group (553.41±158.65 pg/ml vs 48254±110.16 pg/ml, P=0.021). Compared with the HBV-ACLF death group, the HBV-ACLF survival group had a significantly lower level of IL-32 (481.95±100.67 pg/ml vs 540.62±112.45 pg/ml, P=0.011) and a significantly higher level of IL-10 (4.21±1.27 pg/ml vs 3.61±1.05 pg/ml, P=0.038). ConclusionThe cytokine network plays an important role in the pathogenesis of HBV-ACLF. Serum IL-32 and IL-10 may be involved in disease progression, and dynamic monitoring of their levels helps with prognostic prediction.
【关键字】:肝功能衰竭; 肝炎病毒, 乙型; 白细胞介素10; 白细胞介素32
【Key words】:liver failure; hepatitis B virus; interleukin-10; interleukin-32
【引证本文】:GU J, WANG Y, CHEN L, et al. Changes in serum levels of interleukin-32 and interleukin-10 and their clinical significance in patients with HBV-related acute-on-chronic liver failure[J]. J Clin Hepatol, 2018, 34(4): 801-805. (in Chinese)
顾静, 王艳, 陈丽, 等. HBV相关慢加急性肝衰竭患者血清IL-32和IL-10水平变化及意义[J]. 临床肝胆病杂志, 2018, 34(4): 801-805.

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