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目的探讨乙肝急性肝损伤中机制中的促炎因子及抗炎因子失衡情况与临床价值。方法选取2008年1月~2012年12月普宁市人民医院收治的40例乙肝急性肝损伤患者,按照病情程度均分为病情改善组和病情恶化组(n=20)。同时选取20例同期健康体检者作为对照组,对入院时的乙肝急性肝损伤患者,进行凝血酶原时间与肝功能检查,并对比分析3组研究对象促炎因子与抗炎因子的水平,比较2组乙肝急性肝损伤患者入院时与治疗后的促炎因子与抗炎因子的水平变化情况。结果 2组乙肝急性肝损伤患者入院时的丙氨酸氨基转移酶(ALT)>1000 U/L;病情恶化组的促炎因子TNF-α、IFN-γ、IL-17、IL-35水平均显著高于病情改善组与对照组(P<0.05),而病情恶化组的抗炎因子IL-10、TGF-β水平均显著低于病情改善组(P<0.05);抗炎因子IL-10、IL-35水平与入院时相比,差异有统计学意义(P<0.05);病情改善组患者治疗后抗炎因子IL-10、TGF-β、IL-35水平及促炎因子TNF-α、IFN-γ、IL-17水平,分别与入院时相比较,差异有统计学意义(P<0.05)。结论抗炎因子与促炎因子水平在乙肝急性肝损伤患者中出现失衡,对患者的促炎因子与抗炎因子相关指标进行检测,有利于进一步了解与判断患者肝组织损伤程度,促炎因子水平高,则可能导致病情恶化,抗炎因子水平高,则有利于病情的改善,值得临床推广应用。
Objective To investigate the imbalance and clinical value of proinflammatory cytokines and anti-inflammatory cytokines in the pathogenesis of acute liver injury induced by hepatitis B virus. Methods Forty patients with acute liver injury of hepatitis B admitted from Puning People ’s Hospital from January 2008 to December 2012 were divided into two groups: condition improvement group and condition deterioration group (n = 20). At the same time, 20 healthy subjects were selected as the control group. Prothrombin time and liver function tests were performed on patients with acute hepatitis B at admission. The levels of proinflammatory cytokines and anti-inflammatory cytokines were compared among the three groups Two groups of acute liver injury in patients with hepatitis B admission and after treatment of proinflammatory cytokines and anti-inflammatory cytokines levels. Results The serum levels of alanine aminotransferase (ALT)> 1000 U / L were significantly higher in patients with acute liver injury of hepatitis B than those in patients with exacerbation. The levels of TNF-α, IFN-γ, IL-17 and IL- (P <0.05), while the levels of anti-inflammatory cytokines IL-10 and TGF-βwere significantly lower in the patients with exacerbation than those in the patients with exacerbation (P <0.05). The levels of anti-inflammatory cytokines IL-10 (P <0.05). The levels of IL-10, TGF-β and IL-35 in anti-inflammatory and anti-inflammatory cytokines after treatment in patients with exacerbation were significantly higher than those on admission , IFN-γ, IL-17 levels, respectively, compared with admission, the difference was statistically significant (P <0.05). Conclusion The levels of anti-inflammatory and proinflammatory cytokines in patients with acute hepatitis B are unbalanced, and the correlation of proinflammatory cytokines and anti-inflammatory cytokines in patients with hepatitis B is detected, which is helpful for further understanding and judging the degree of liver injury, the level of proinflammatory cytokines High, may lead to exacerbations, high levels of anti-inflammatory factors, it is conducive to the improvement of the disease, it is worth promoting the clinical application.