【摘要】 [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。更多还原

【Abstract】 [Objective]To investigate the level and clinical significance of cytokine levels in patients with HBV related liver failure.[Methods]48cases of hepatitis B associated ACLF patients,48 patients with CHB,and 20 healthy controls were selected in our hospital from August 2012 to July 2015.The levels of IL-6,IL-8,IL-10,TNF-αand IFN-γof the three groups were detected,and the clinical indicators of the patients were recorded and analyzed.[Results]The IL-6,IL-8and TNF-αlevels in ACLF group was significantly higher than that of CHB group,(t=4.287,-11.609,-3.310,P<0.001),and the difference was statistically significant.They were significantly higher in CHB group than that of control group,(t=2.588,2.152,2.977,P=0.012,0.035,0.004),and the difference was statistically significant.ACLF group was also significantly higher than that of control group(t=3.132,10.402,-4.122,P<0.001),and the difference was statistically significant.There was no significant difference between the three groups in IL-10 and IFN-γ(P>0.05).The MELD score,IL-6,and TNF-level in the death group were significantly higher than those in the control group(P=0.021,0.038,0.016),and the difference was statistically significant.There was no significant difference in IL-8level between the two groups(P=0.075).The level of IL-6and TNF-αwas positively correlated with MELD score(r=0.487,0.402,P=0.013,0.037).Other cytokines had no significant correlation with the clinical parameters such as MELD score,ALT,AST and so on.[Conclusion]Cytokines play an important role in the occurrence and development of HBV related ACLF.IL-6and TNF-γmay be related to the prognosis of the patients,which can promote the occurrence and development of the disease.更多还原