外周血白细胞介素32和金属基质蛋白酶-2对HBV相关慢加急性肝衰竭预后的预测价值研究

目的探讨外周血白细胞介素(interleukin,IL)-32和金属蛋白酶(matrix metalloproteinases,MMP)-2表达水平对HBV相关慢加急性肝衰竭(HBV-associated acute-on-chronic liver failure,HBV-ACLF)预后的预测价值。方法选择34例HBV-ACLF和31例慢性乙型肝炎(chronic hepatitis B,CHB)患者作为研究对象,检测外周血IL-32和MMP-2的表达水平,并与ALT、AST、TBIL、ALB及PT等指标进行相关性分析;采用Logisitic回归分析IL-32和MMP-2预测HBV-ACLF预后的价值。结果 HBV-ACLF组IL-32与TBIL、PT呈中等程度正相关(r_s=0.774、0.686),与ALB呈弱负相关(r_s=-0.456);MMP-2与ALB呈弱负相关(r_s=-0.451);IL-32与MMP-2呈弱正相关(r_s=0.580)。CHB组IL-32与TBIL、PT呈弱正相关(r_s=0.439、0.555);MMP-2与AST呈弱正相关(r_s=0.417),与ALB呈弱负相关(r_s=-0.541),与TBIL、PT呈中等程度正相关(r_s=0.647、0.766);IL-32与MMP-2呈弱正相关(r_s=0.590)。HBV-ACLF组、CHB组和对照组外周血IL-32表达水平呈依次升高(P均0.05)。HBV-ACLF组MMP-2表达高于CHB组和对照组(P均0.05),但CHB组与对照组相比,差异无统计学意义。在合并感染率、外周血IL-32和MMP-2表达水平方面,HBV-ACLF组明显高于CHB组。Logisitic回归分析发现IL-32与HBV-ACLF的预后密切相关。结论外周血IL-32和MMP-2的表达水平可反映肝损伤严重程度;IL-32与HBV-ACLF的预后密切相关。

Predictive value of interleukin-32 and matrix metalloproteinases-2 in peripheral blood for the prognosis of HBV-related acute-on-chronic liver failure

Objective To investigate the predictive value of the levels of interleukin ( IL )-32 and matrix metalloproteases (MMP)-2 in peripheral blood for the prognosis of patients with HBV-related acute-on-chronic liver failure (HBV-ACLF). Methods To-tally 34 HBV-ACLF patients and 31 patients with chronic hepatitis B (CHB) were enrolled in the study. The levels of IL-32 and MMP-2 in peripheral blood were detected by ELISA. The relationships between IL-32, MMP-2 and ALT, AST, TBIL, ALB, PT were analyzed. The logistic binary regression was used to analyze the predictive value of the levels of IL-32 and MMP-2 for the prognosis of HBV-ACLF. Results In HBV-ACLF group, IL-32 had a moderately positive correlation with TBIL and PT (rs=0.774,0.686), and a weakly negative correlation with ALB (rs=-0.456);MMP-2 and ALB were weakly negatively correlated (rs=-0.451);IL-32 and MMP-2 were weakly positively correlated (rs=0.580). In CHB group, IL-32 was weakly positively correlated with TBIL and PT (rs=0.439, 0.555);MMP-2 was weakly positively correlated with AST(rs=0.417), weakly negatively correlated with ALB(rs=-0.541), and moderately posi-tively correlated with TBIL and PT(rs=0.647, 0.766);IL-32 and MMP-2 were weakly positively correlated(rs=0.590). The level of IL-32 in peripheral blood increased in turn in HBV-ACLF group, CHB group and control group (P<0.05). The level of MMP-2 in HBV-ACLF group was significantly higher than that in CHB group and control group (P<0.05), but the level was not significantly differ-ent between CHB group and control group. Compared with CHB group, the occurrence of co-infection was more frequent, and the levels of MMP-2 and IL-32 were higher in HBV-ACLF group. Logisitic regression analysis showed that IL-32 was closely correlated with the prognosis of ACLF. Conclusions The levels of IL-32 and MMP-2 in peripheral blood can reflect the degree of liver injury. IL-32 is closely correlated with the prognosis of HBV-ACLF.