【摘要】 目的探讨细胞因子对药物性肝损伤(DILI)患者肝功能恢复的预测价值。方法采用珠基免疫测定法检测100例DILI患者治疗前后外周血清中12种细胞因子水平,包括IL-1α、IL-1β、IL-3、IL-11、IL-12p40、IL-15、IL-18、IL-23、IL-27、IFN-α、胸腺基质淋巴生成素(TSLP)和粒细胞-巨噬细胞集落刺激因子(GM-CSF),分析细胞因子与DILI患者肝功能指标的相关性。结果与治疗前比较,治疗后血清ALT和AST水平均降低(P<0.01),血清IL-1α、IL-23、IL-27和IFN-α水平降低,而血清IL-1β和GM-CSF水平升高(P<0.05)。血清ALT、AST水平分别与血清IL-1α和IL-23水平呈正相关,而与血清IL-1β和GM-CSF水平呈负相关(P<0.01)。血清IL-23水平对血清ALT和AST水平均有影响(P<0.05),血清IL-1α、IL-1β和GM-CSF水平对血清AST水平亦有影响(P<0.01或P<0.05)。结论血清IL-23水平对DILI患者肝功能恢复有较大的预测价值。更多还原

【Abstract】 Objective To explore the value of cytokine levels in predicting the liver function recovery in the patients with drug-induced liver injury(DILI).Methods Twelve cytokines in peripheral blood of 100 DILI patients before and after treatment were detected by bead-based immunoassay, which included IL-1α,IL-1β,IL-3,IL-11,IL-12 p40,IL-15,IL-18,IL-23,IL-27,IFN-α,thymic stromal lymphopoietin(TSLP) and granular macrophage colony stimulating factor(GM-CSF).The correlation between cytokines and liver function indexes of DILI patients was analyzed.Results Compared with before, serum levels of ALT and AST were decreased(P<0.01),those of serum IL-1α,IL-23,IL-27 and IFN-α were decreased, and those of IL-1β and GM-CSF were increased after treatment(P<0.05).Serum levels of ALT and AST were positively correlated with serum levels of IL-1α and IL-23 and negatively correlated with those of IL-1β and GM-CSF,respectively(P<0.01).Serum IL-23 level had significant effect on serum levels of ALT and AST(P<0.05).Serum levels of IL-1α,IL-1β and GM-CSF had significant effects on serum AST level(P<0.01 or P<0.05).Conclusion Serum IL-23 level has great predictive value for liver function recovery in the patients with DILI.更多还原