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目的白细胞介素-1受体拮抗剂(IL-1ra)是炎症细胞因子IL-1的天然拮抗剂,在许多炎症性疾病中发挥关键作用。本研究探讨IL-1ra在乙型肝炎相关肝衰竭(HB-ACLF)中的作用。方法采集31例HB-ACLF、28例急性乙型肝炎(AHB)、31例慢性乙型肝炎(CHB)患者及15例健康对照者(healthy controls,HC)外周静脉血,用QPlex法检测外周血IL-1ra、IL-1β、IL-6、IL-4、IL-10、TNF-α及IFN-γ浓度,并分析肝衰竭患者存活组与死亡组各细胞因子的差异。结果 HB-ACLF患者血清IL-1ra平均浓度为(338.9±268.8)pg/ml,与AHB[(182.7±123.1)pg/ml,P=0.012]、CHB[(77.07±40.5)pg/ml,P<0.001]及HC[(37.9±15.6)pg/ml,P<0.001]比较,浓度最高。但HB-ACLF患者IL-1ra/IL-1β比例(2.96±1.54)较AHB患者(4.54±2.29)低(P=0.048)。AHB患者血清IL-1ra浓度亦较CHB患者(P<0.001)及HC(P<0.001)高。在HB-ACLF患者中,最终死亡患者外周血IL-1ra浓度(P=0.02)及IL-1ra/IL-1β比值(P=0.007)均比存活者低。结论 IL-1ra在HB-ACLF发展过程中起重要作用,与HB-ACLF患者预后相关。
AIM Interleukin-1 receptor antagonist (IL-1ra) is a natural antagonist of the inflammatory cytokine IL-1 and plays a key role in many inflammatory diseases. This study explored the role of IL-1ra in hepatitis B-related liver failure (HB-ACLF). Methods Peripheral venous blood was collected from 31 patients with HB-ACLF, 28 with acute hepatitis B (AHB), 31 with chronic hepatitis B (CHB) and 15 with healthy controls (HC). QPlex was used to detect peripheral blood IL-1ra, IL-1β, IL-6, IL-4, IL-10, TNF-α and IFN-γ in patients with liver failure were analyzed. Results The mean concentration of IL-1ra in patients with HB-ACLF was (338.9 ± 268.8) pg / ml, which was significantly higher than that of AHB [(182.7 ± 123.1) pg / ml, <0.001] and HC [(37.9 ± 15.6) pg / ml, P <0.001]. However, the proportion of IL-1ra / IL-1β in HB-ACLF patients (2.96 ± 1.54) was lower than that in AHB patients (4.54 ± 2.29) (P = 0.048). The level of IL-1ra in AHB patients was also higher than that in CHB patients (P <0.001) and HC (P <0.001). In HB-ACLF patients, the concentrations of IL-1ra (P = 0.02) and IL-1ra / IL-1β (P = 0.007) were lower in survivors than in survivors. Conclusion IL-1ra plays an important role in the development of HB-ACLF and is associated with the prognosis of patients with HB-ACLF.