HBV相关慢加急性肝衰竭患者体内细胞因子表达及动态变化的研究

目的 探讨乙型肝炎相关慢加急性肝衰竭(HBV-related acute-on-chronic liver failure,HBV-ACLF)患者体内细胞因子表达及动态变化的临床意义.方法 选择我院2010年3-10月收治的HBV-ACLF患者43例(HBV-ACLF组),同时选取同期慢性乙型肝炎(chronic he...

Expression and dynamic changes of cytokine levels in patients with HBV-related acute-on-chronic liver failure

Objective To investigate clinical significance of expression and dynamic changes of cytokine levels in HBV-relat-ed acute-on-chronic liver failure(HBV-ACLF) patients.Methods Totally 43 HBV-ACLF patients(HBV-ACLF group) and 46 pati-ents with chronic hepatitis B(CHB)(CHB group),who were treated in our hospital from Mar.to Oct.2010,and 20 healthy controls(HC group) were included in the study.ELISA was used to detect the levels of interleukin(IL)-1β,IL-6,IL-10,transforming growth factor(TGF)-β1 and tumor necrosis factor(TNF)-α in the 3 groups.Meanwhile,clinical parameters were investigated.The 43 HBV-ACLF patients were given 3 weeks of follow-up,and the changes of serum cytokine levels were observed dynamically.Results The le-vels of IL-1β,IL-6,IL-10 and TGF-β1 in HBV-ACLF group were higher than those in CHB group and in HC group(P<0.05),and the level of TNF-α in HBV-ACLF group was higher than that in HC group(P<0.05).In HBV-ACLF group,the level of IL-6 was positively correlated with the levels of TGF-β1 and HBV DNA and model for end-stage liver disease(MELD) score(r=0.403,P<0.01;r=0.322,P<0.05;r=0.338,P<0.05);the level of IL-10 was positively correlated with that of CHE(r=0.411,P<0.01),and nega-tively correlated with Na +(r=-0.529,P<0.01);the level of TGF-β1 was positively correlated with that of CHE(r=0.407,P<0.01).The level of IL-1 in medium and late stage HBV-ACLF group was higher than that in early stage group(P<0.05).The level of TGF-β1 in medium stage HBV-ACLF group was higher than that in early stage group(P<0.05).The levels of IL-6,TGF-β1 and TNF-α in cured or improved group showed a gradually decreasing trend,and the levels of IL-6 and TGF-β1 were lower than those in dead or inefficient group in the 3rd week of follow-up(P<0.05).Conclusions HBV-ACLF patients suffered from immune dysfunction of proinflammatory cytokines and anti-inflammatory cytokines.The expression and dynamic changes of cytokine levels have a good clinical significance in the disease progression and prognosis of HBV-ACLF patients.