【摘要】 目的探讨白细胞介素-10(IL-10)基因多态性与汉族人群原发性肝硬化(PBC)发病率、病情及预后的关系。方法选取2011年5月至2015年5月间在该院就诊并确诊为PBC的患者480例作为研究对象(观察组),并以同期480例健康体检人群为对照组,检测患者血清中IL-10基因-1082A/A多态性,采用Child分级和MELD评分评价患者病情,并采用Logistics回归性分析探讨PBC患者死亡的危险因素。结果观察组患者IL-10基因-1082G/A基因型为A/A占47.5%(76例),明显高于对照组患者的14.2%,基因型为A/A的患者患PBC的风险是C/C的2.8倍,A/C患者患PBC的风险为C/C的1.6倍,含A基因患者患PBC的风险为不含A基因的1.9倍,观察组基因型为A/A患者IL-10和肿瘤坏死因子α水平分别为(33.6±9.5)、(18.9±7.3)ng/L,明显高于其他基因型,A/A基因型患者Child分级评分和MELD评分分别为(8.6±1.8)分和(31.5±3.6)分,明显高于A/C、C/C、Any A基因型的患者,IL-10基因-1082A/A(P=0.01)、IL-10(P=0.02)、MELD评分(P=0.01)是PBC患者死亡的独立危险因素。结论 IL-10--592A/A基因型为A/A的患者PBC发生率明显增加,病情更严重,是患者预后不良的独立危险因。更多还原

【Abstract】 Objective To investigate the relationship between interleukin-10 gene polymorphism and the incidence,condition and prognosis of primary cirrhosis in Han nationality.Methods A total of 480 patients with primary biliary cirrhosis(observation group)who were diagnosed in the hospital from May 2011 to May 2015 were enrolled in this study.480 healthy people in the same period were selected as the control group.The IL-10 gene-1082 A/A polymorphism was detected in all subjects,and the condition of the observation group was evaluated by Child classification and MELD score.Logistics regression analysis was used to investigate the risk factors of death in patients with primary cirrhosis.Results In the observation group,the IL-10-1082 G/A genotype of A/A accounted for 47.5%(76 cases),which was significantly higher than the control group(14.2%).The risk of PBC in patients with genotype A/A was 2.8 times that of C/C,the risk of PBC in patients with genotype A/A was 1.6 times that of C/C,and the risk of PBC in patients with A gene was 1.9 times that of A-free gene.The levels of IL-10 and TNF-αin the observation group whose genotype were A/A were(33.6±9.5)and(18.9±7.3)ng/L,respectively,which were significantly higher than other genotypes.The Child score and MELD score of patients with A/A genotype were(8.6±1.8)and(31.5±3.6),respectively,which were significantly higher than those of A/C,C/C,Any A genotype.IL-10 gene-1082 A/A(P=0.01),IL-10(P=0.02),and MELD score(P=0.01)were independent risk factors for death in patients with PBC.Conclusion Patients with IL-10-gene-1082 A/A genotype of A/A have an increased rate of primary biliary cirrhosis and a more serious condition,which is an independent risk factor for poor prognosis.更多还原