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目的探讨血清白细胞介素37(IL-37)在慢性乙型肝炎(CHB)、乙型慢加急性肝衰竭(ACHBLF)和乙型肝炎后肝硬化(PHBC)中的意义。方法分别选取2015年10月至2016年10月中山大学附属第三医院门诊和住院部就诊的CHB患者49例、ACHBLF患者20例和PHBC患者18例,健康对照组34例为本院健康志愿者,检测各组血清中谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBil)、HBV-DNA、IL-37、TNFα的水平。结果 CHB、ACHBLF和PHBC组患者中,血清IL-37的表达水平明显高于对对照组,且HBe Ag阳性患者血清IL-37较HBe Ag阴性患者明显升高,差异均有统计学意义(P均<0.05)。HBV感染者中,HBV DNA阳性患者血清IL-37明显高于HBV DNA阴性患者,差异有统计学意义(P<0.05)。CHB和ACHBLF组患者血清IL-37与ALT、AST、HBV DNA呈正相关(R=0.608 4,R=0.574 4,R=0.649 2,P均<0.05;R=0.636 8,R=0.678 2,R=0.978 5,P均<0.05);CHB、ACHBLF和PHBC患者血清IL-37与TBil、TNFα无相关性(P>0.05)。结论 CHB、ACHBLF和PHBC患者血清IL-37的表达可能与HBV DNA水平和HBe Ag血清学转换有关,并能够反映CHB、PHBC患者肝脏炎症程度。IL-37可作为乙型肝炎治疗的一个新指标。
Objective To investigate the significance of serum interleukin-37 (IL-37) in chronic hepatitis B (CHB), acute hepatotoxicosis B (ACHBLF) and post-hepatitis B cirrhosis (PHBC). Methods 49 cases of CHB patients, 20 cases of ACHBLF and 18 cases of PHBC were selected from the outpatient and inpatient departments of the Third Affiliated Hospital of Sun Yat-sen University from October 2015 to October 2016. The 34 healthy controls were selected as healthy volunteers Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), HBV-DNA, IL-37 and TNFα were detected in all groups. Results The serum levels of IL-37 in CHB, ACHBLF and PHBC groups were significantly higher than those in control group, and the levels of serum IL-37 in HBeAg-positive patients were significantly higher than those in HBeAg-negative patients (P All <0.05). Among HBV infected patients, the serum IL-37 in HBV DNA positive patients was significantly higher than that in HBV DNA negative patients, the difference was statistically significant (P <0.05). Serum levels of IL-37 in patients with CHB and ACHBLF were positively correlated with ALT, AST and HBV DNA (R = 0.608 4, R = 0.574 4, R = 0.649 2, P <0.05; = 0.9785, P <0.05). No correlation was found between serum IL-37 and TBil and TNFα in patients with CHB, ACHBLF and PHBC (P> 0.05). Conclusions The serum IL-37 level in patients with CHB, ACHBLF and PHBC may be related to HBV DNA level and HBeAg seroconversion, and can reflect the degree of liver inflammation in CHB and PHBC patients. IL-37 can be used as a new indicator of hepatitis B treatment.