乙型肝炎肝硬化患者血清sICAM-1、IL-18水平与HBV复制的关系

目的：探讨乙型肝炎肝硬化患者血清可溶性细胞黏附分子-1（sICAM-1）、白细胞介素-18（IL-18）的变化与乙型肝炎病毒（HBV）复制的关系。方法：采用ELIAS对60例乙型肝炎肝硬化患者和30例健康人血清sICAM-1、IL-18水平进行测定,用荧光定量PCR仪检测60例乙型肝炎肝硬化患者HBV-DNA含量。结果：肝硬化组患者血清sICAM-1、IL-18水平明显高于健康对照组（P〈0.01）,血清sICAM-1水平与IL-18呈显著正相关（r=0.432,P〈0.01）;肝硬化患者HBV-DNA阳性组血清sICAM-1水平与HBV-DNA阴性组相比较无显著性差异（P〉0.05）;肝硬化患者HBV-DNA阳性组血清IL-18水平与HBV-DNA阴性组相比较有显著性差异（P〈0.01）。结论：sICAM-1水平变化与HBV的复制水平无关,继发性免疫反应导致sICAM-1表达,sICAM-1造成肝细胞损伤;IL-18水平变化与HBV复制活跃程度相关,测定IL-18活性,在监测HBV病毒复制状态及抗病毒治疗等方面都具有一定的实用价值。

The Relation between HBV-DNA Replication and the Changing Levels of Serum sICAM-1 and IL-18 in Patients with Hepatitis B Cirrhosis

Objective： To investigate the changes of serum soluble intercellular adhesion molecule-1（sICAM-1） and interleukin-18（IL-18） in patients with type B hepatitis cirrhosis,and their relationship with HBV replication.Methods： Serum levels of sICAM-1 and IL-18 of 60 type B hepatitis cirrhosis patients（group A） and 30 normal persons（group B） were detected with enzyme linked immunosorbent assay（ELISA）.The serum level of HBV-DNA in patients of group A was detected with fluorescent quantitative PCR.Results： The serum levels of sICAM-1 and IL-18 in group A were significantly higher than those in group B（P〈0.01）.There was a positive correlation between serum levels of sICAM-1 and IL-18.There was no significant difference in serum levels of sICAM-1 between HBV-DNA positive group and HBV-DNA negative group in group A（P〈0.05）,but there was significant difference in serum levels of IL-18 between them in group A（P〈0.01）.Conclusions： The change of serum level of sICAM-1 in patients with type B hepatitis cirrhosis does not relate to replication of HBV.It suggests that secondary immune injury lead to the expression of sICAM-1,which results in injury of liver cells.Since change of IL-18 serum level in these patients relates to replication of HBV,measuring IL-18 level has some practical value in monitoring HBV replication and antiviral therapy application.