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[目的]观察细胞因子水平在乙肝相关性肝衰竭患者中的水平变化,探讨其表达意义。[方法]选取于2012年8月~2015年7月来我院就诊的乙肝相关性慢加急性肝衰竭(ACLF)患者48例、慢性乙型肝炎(CHB)患者48例和健康对照患者20例。检测3组患者IL-6、IL-8、IL-10、TNF-α、IFN-γ水平,检测3组患者各项临床指标进行分析。[结果]3组间IL-6、IL-8和TNF-α水平分析可见,ACLF组明显高于CHB组,差异有统计学意义(P<0.001);CHB组明显高于对照组,差异有统计学意义(P<0.01);ACLF组明显高于对照组,差异有统计学意义(P<0.001)。IL-10、IFN-γ在3组间差异无统计学意义。死亡组的MELD评分、IL-6、TNF-α水平明显高于对照好转组,差异有统计学意义(P<0.05)。IL-8水平在2组间比较差异无统计学意义。IL-6、TNF-α水平与MELD评分明显呈正相关(r=0.487、0.402,P=0.013、0.037)。其他细胞因子与MELD评分、ALT、AST等临床指标间无明显相关性。[结论]细胞因子在HBV相关ACLF患者的疾病发生、发展过程中有重要作用,其中,IL-6、TNF-α可能与患者的预后有关,促进患者疾病的发生发展。
[Objective] To observe the changes of cytokine levels in patients with hepatitis B-related liver failure and to explore its significance. [Methods] Forty-eight patients with hepatitis B-associated chronic liver failure (ACLF), 48 patients with chronic hepatitis B (CHB) and 20 healthy controls were enrolled in our hospital from August 2012 to July 2015. . The levels of IL-6, IL-8, IL-10, TNF-α and IFN-γ in the three groups were detected and the clinical parameters of three groups were detected. [Results] The levels of IL-6, IL-8 and TNF-α in the three groups were significantly higher in ACLF group than in CHB group (P <0.001). The CHB group was significantly higher than that in control group Statistical significance (P <0.01); ACLF group was significantly higher than the control group, the difference was statistically significant (P <0.001). IL-10, IFN-γ in the three groups showed no significant difference. The MELD score, IL-6 and TNF-α levels in the death group were significantly higher than those in the control group (P <0.05). IL-8 levels in the two groups showed no significant difference. The levels of IL-6 and TNF-α were positively correlated with MELD scores (r = 0.487, 0.402, P = 0.013,0.037). Other cytokines and MELD score, ALT, AST and other clinical indicators no significant correlation between. [Conclusion] Cytokines play an important role in the pathogenesis and progression of HBV-related ACLF. Among them, IL-6 and TNF-α may be related to the prognosis of patients and promote the occurrence and development of the disease.