脂肪肝肝损伤与CRP及IL-18的相关性分析

目的：探讨白细胞介素-18（IL-18）、CRP在脂肪肝肝损伤中的作用及其临床意义.方法：应用酶联免疫吸附法（ELISA）检测36例酒精性脂肪肝（AFLD）、36例非酒精性脂肪肝（NAFLD）和30例正常对照组（NC）的血清IL-18的水平;CRP采用免疫透射比浊法测定;以及生化方法检测血脂（TG）、丙氨酸氨基转移酶（ALT）、γ-谷氨酰转移酶（GGT）、总胆红素（TBIL）的水平,测量身高、体重、腹围,并计算体重指数（BMI）.结果：AFLD、NAFLD组血清IL-18及CRP的水平与NC组均有显著差异（P＜0.05）;而且,此两组间比较亦有显著差异（P＜0.05）;脂肪肝患者血清ALT、GGT、TG及腹围、BMI与NC组比较均有显著差异（P＜0.05）;脂肪肝患者血清IL-I8与ALT、CRP均呈正相关关系.结论：IL-18、CRP在脂肪肝肝损伤的发病机制中具有重要的作用,其水平与脂肪肝患者肝损伤的严重程度有密切关系,可以作为辅助诊断脂肪肝及判断其肝损伤严重程度的一个指标.

The Relationships Between the Changes of Serum IL-18 and C-reactive Protein in Patients with Fatty Liver

Objective：To investigate the clinical significance of the role of serum IL- 18 and C- reactive protein in the pathogenesis of fatty fiver. Methods：Serum IL - 18 levels were detected with enzyme - linked immunosorbent assay（ ELISA） in 36 patients with alcoholic fatty liver disease（AFLD）, 36 patients with non alco- holic fatty liver disease（NAFLD）and 30 controls（NC）. CRP detected by immune transmission turbidity method, and Triglyeride（TG）, alanin aminotransferase （ALT）, gamma - glutamyl transferase （GGT） and total bilirubin （TBIL）levels were detected with biochemical methods, height, weight, abdominal circumference and body mass index（BMI）were measured too. Results：Serum IL- 18 levels were significantly higher in patients with NAFLD （P 〈 0.05） and AFLD（ P 〈 0.05 ） than those in NC group. Moreover, there were also significant differences between the levels of the two groups（P 〈 0.05 ）. Serum levels of ALT, GGT, TG, and abdominal circumference, BMI in patients with fatty fiver disease were significantly higher than those in NC group（P 〈 0.05）, respectively and a positive linear correlation existed between IL - 18 and CRP, ALT, GGT, TBIL, TG, BMI and waist circumference in Patients with fatty liver disease. Conclusion： IL- 18 , CRP, obesity and alcohol played important role in the pathogenesis of fatty fiver. Serum IL - 18 and CRP of levels in patients with fatty liver disease were closely related to the severity of liver injury and might serve as all accessory indicator for diagnosis of fatty liver disease and assessment of the severity.