血清中IL-6和IL-10变化与慢性乙肝急性发作导致肝衰竭的关系

目的通过分析急性发作慢性乙型肝炎（慢性乙肝）患者体内IL-6、IL-12、γ干扰素和IL-10的变化,探讨急性发作及病情严重程度与细胞因子变化的关系。方法对154例急性发作及免疫耐受慢性乙肝患者采用ELISA法检测IL-6、IL-12、γ干扰素和IL-10的水平,同时检测肝功能、HBV DNA定量等。结果处于急性发作的患者年龄较大,HBV DNA定量较低,促炎症因子和抗炎症因子的水平均高于处于免疫耐受的患者;重型肝炎组IL-6的水平（179.80±134.96）pg/ml高于非重型肝炎组（108.80±113.23）pg/ml（P〈0.05）,而IL-10的水平（12.80±4.96）pg/ml低于非重型肝炎组（20.33±7.35）pg/ml（P〈0.05）。结论慢性乙肝急性发作可能与炎症因子的激活相关,IL-6有促进肝损伤作用,而IL-10可能在避免过强免疫损伤中起重要作用。

The Correlation of the Changes of IL-6 and IL-10 with Liver Function Failure in Chronic Hepatitis B Patients with Hepatic Flare

Objective To detect IL-6,IL-12,IFN-γand IL-10 in patients with hepatic flares and study their association with hepatic flares and the degree of severity in chronic hepatitis B patients.Methods 154 chronic hepatitis B patients with hepatic flare were determined for the levels of IL-6,IL-12,IFN-γ and IL-10 by ELISA.Liver functions and HBV DNA were also measured.Results The age of chronic hepatitis B patients with hepatic flare was older,HBV DNA level was lower,the levels pro-inflammatory and inflammatory cytokines were higher than those immune tolerant patients.In the severe hepatitis group,the IL-6 level（179.80±134.96）pg /ml was higher than that of non-severe group（108.80±113.23）pg /ml（P〈0.05）,but the IL-10 level（12.80±4.96）mg /ml was lower than that of the non-severe group（20.33±7.35）pg /ml（P〈0.05）.Conclusion The inflammatory cytokoines may play important role in hepatic flares in patients with chronic HBV infection.IL-6 may contribute to hepatic injury,but IL10 may have important role on avoiding over immunopathogenesis.