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目的探讨不同HCV基因分型与丙型肝炎肝硬化患者血清中白细胞介素(IL)17、IL-6及维生素D的关系。方法选取2012年1-12月解放军第三〇二医院收治的76例丙型肝炎肝硬化患者,根据基因型不同分为1b型47例和2a型29例。采用ELISA法检测患者血清中IL-17、IL-6及维生素D水平。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验,采用Spearman分析血清中IL-17、IL-6及维生素D与基因分型的相关性。结果在Child-Pugh改良分级结果中,1b型患者中A级所占比例相对于2a型差异具有统计学意义(χ2=4.97,P<0.05);1b型患者的AFP、HCV RNA滴度、IL-17、IL-6、TNFα均高于2a型,差异均有统计学意义(t值分别为21.56、16.51、12.31、10.71、7.23,P值均<0.05),而IFNγ、25-OH-D、1,25(OH)2D低于2a型,差异均有统计学意义(t值分别为3.98、6.32、4.88,P值均<0.05);Spearman相关性分析发现,AFP、HCV RNA滴度、IL-6、IL-17与1b型、2a型基因均呈正相关(P值均<0.05),而IFNγ、TNFα和25-OH-D与1b型、2a型基因呈负相关(P值均<0.05)。结论 1b型患者血清中IL-17、IL-6、AFP及HCV RNA水平均高于2a型患者,而维生素D低于2a型患者,血清中IL-17、IL-6、25-OH-D、AFP及HCV RNA与基因分型有一定的相关性,而1,25(OH)2D则与基因分型无关。
Objective To investigate the relationship between different HCV genotypes and interleukin (IL) 17, IL-6 and vitamin D in patients with hepatitis C cirrhosis. Methods Sixty-six patients with hepatitis C cirrhosis who were admitted to the 302 Hospital of PLA from January to December in 2012 were divided into 47 cases of type 1b and 29 cases of type 2a according to genotypes. Serum levels of IL-17, IL-6 and vitamin D were measured by ELISA. The t test was used to compare the measurement data, and theχ2 test was used to compare the data between groups. Spearman analysis was used to analyze the correlation between serum IL-17, IL-6 and vitamin D and genotyping. Results In the improved Child-Pugh classification, the proportion of type A patients in type 1b was significantly different from that of type 2a patients (χ2 = 4.97, P <0.05). The AFP, HCV RNA titer, IL -17, IL-6 and TNFα were all higher than those in 2a type (t = 21.56,16.51,12.31,10.71,7.23, P <0.05 respectively), but IFNγ, 25-OH-D , 1,25 (OH) 2D was lower than that of type 2a (t = 3.98,6.32,4.88 respectively, P <0.05). Spearman correlation analysis showed that the titer of AFP and HCV RNA, IL-6 and IL-17 were positively correlated with type 1b and type 2a genes (all P <0.05), while IFNγ, TNFα and 25-OH-D were negatively correlated with type 1b and type 2a genes (P < 0.05). Conclusions The serum levels of IL-17, IL-6, AFP and HCV RNA in type 1b patients are higher than those in type 2a patients. However, the serum levels of IL-17, IL-6 and 25-OH-D , AFP and HCV RNA had some correlation with genotyping, while 1,25 (OH) 2D was not related to genotyping.