动态检测慢加急(亚急)性肝衰竭病人细胞因子的临床意义

目的 动态观察慢加急(亚急)性肝衰竭(ACLF)的白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、γ干扰素(IFN-γ)、肿瘤坏死因子-α(TNF-α)在不同病程时期(第0周、第8周)的变化,分析其临床意义.方法 采用酶联免疫吸附法(ELISA),检测急性肝衰竭组(ACLF)、慢性乙型肝炎组(CHB)、健康对照组的血清,第0周与治疗后第8周与其他两组进行比较.结果 (1)治疗前(第0周),ACLF组的IL-2、IL-4、L-6、IL-10、IFN-γ、TNF-α水平均高于CHB、对照组,差异有统计学意义;(2)ACLF组经过治疗第8周时,ACLF组的IL-2、IL-4、IL-6、IL-10、IFN-γ、TNF-α水平均有显著下降,但ACLF组水平仍高于CHB组和对照组;(3)存活组与死亡组比较,死亡组病人IL-2、IL-4、IL-6、IFN-γ、TNF-α水平高于存活组,差异有统计学意义(P<0.01);死亡组病人IL-10水平低于存活组,差异有统计学意义(P<0.05);两组病人的IFN-γ水平差异无统计学意义.结论 动态检测ACLF病人的IL-2、IL-4、IL-5、IL-6、IL-10、IFN-γ、TNF-α水平,对病情轻重及转归有一定指导意义.

Dynamic observation of cytokines in chronic and acute liver failure and clinical significance

Objective To analyze the dynamic observation of the level change of interleukin 2 (IL-2) and interleukin 4 (IL-4),interleukin 6 (IL-6) and interleukin 10 (IL-10),γ interferon (IFN-γ),tumor necrosis factor-α (TNF-α) of slow urgent hepatic failure (ACLF) in different course (0,8 weeks) and its clinical significance.Method The enzyme-linked immunosorbent assay (ELISA) was taken to determine the inflammatory level of serum from ACLF group,chronic hepatitis B (CHB) group and healthy controls group in week 0 and 8 weeks after treatment and compared.Results (1) Levels of ACLF IL-2,IL-4,IL-6,IL-10,IFN-γ and TNF-α in Group (0 weeks) before treatment were higher than that in CHB group and healthy control group.The difference was statistically significant.(2) After treatment for 8 weeks,levels of IL-2,IL-4,IL-6,IL-10,IFN-γ,TNF-α showed a significant decline in the ACLF group.However levels in ACLF group are still higher than that in CHB group and healthy control group.(3) Serum levels in survival group were compared with that in death group.Levels of IL-2,IL-4,IL-6,IFN-γ and TNF-α in death group are higher than that in the survival group,the difference was statistically significant (P<0.01);IL-10 levels in death group are lower than that in the survival group,the difference was statistically significant (P<0.05).There was no statistically significant difference in the IFN-γ level between the two groups.Conclusion The dynamic detection of IL-2,IL-4,IL-5,IL-6,IL-10,IFN-γ,TNF-α levels in patients with ACLF might be of great significance in assessing severity and prognosis.