乙型肝炎肝硬化患者血清B7-H3和IL-18水平变化及其临床意义探讨

目的通过检测乙型肝炎肝硬化患者血清B7-H3和白细胞介素-18(IL-18)水平,探讨它们水平变化与疾病进展的相关性。方法 2015年4月～2017年3月纳入113例乙型肝炎肝硬化患者,其中代偿期肝硬化患者33例,失代偿期肝硬化患者80例,和健康志愿者20名。采用ELISA法检测血清B7-H3和IL-18水平,采用直线相关分析肝硬化患者血清B7-H3与IL-18水平间的相关性。结果 80例失代偿期肝硬化患者血清B7-H3水平为(62.29±22.17) ng/ml,显著高于33例代偿期肝硬化患者的(32.27±10.29) ng/ml(P<0.05)或20例健康人的(11.35±4.48) ng/ml(P<0.05),代偿期肝硬化患者血清B7-H3水平也显著高于健康人(P<0.05);失代偿期肝硬化患者血清IL-18水平为(585.63±121.28) pg/ml,显著高于代偿期肝硬化患者的(396.29±86.91) pg/ml(P<0.05)或健康人的(155.31±76.93) pg/ml(P<0.05),代偿期肝硬化患者血清IL-18水平也显著高于健康人(P<0.05);肝硬化患者血清B7-H3水平与IL-18水平间呈显著正相关(r=0.4111,P<0.01);26例Child-Pugh C级患者血清B7-H3水平为(76.53±22.76) ng/ml,显著高于33例Child-Pugh A级患者的(23.27±9.84) ng/ml或54例Child-Pugh B级患者的(52.21±13.94) ng/ml(P<0.05),Child-Pugh C患者IL-18水平为(594.13±112.21) pg/ml,显著高于Child-Pugh B级患者的(408.06±92.41) pg/ml或Child-Pugh A级患者的(243.82±57.03) pg/ml (P<0.05),Child-Pugh B级患者血清IL-18水平也显著高于Child-Pugh A级(P<0.05)。结论乙型肝炎肝硬化患者血清B7-H3和IL-18水平升高,两者呈正相关,提示B7-H3可能是乙型肝炎肝硬化患者一个预后不良因子,通过与IL-18的协同作用,引起体内免疫功能紊乱,加重了肝细胞损伤,从而促进了疾病的发生和发展。

Serum B7-H3 and IL-18 levels in patients with hepatitis B liver cirrhosis

Objective To investigate the changes of serum B7-H3 and IL-18 levels in patients with hepatitis B liver cirrhosis and their clinical implication. Methods 113 patients with liver cirrhosis,including compensated liver cirrhosis in 33 and decompensated in 80,and 20 healthy volunteers at the same period were recruited in this study between April 2015 and March 2017. Serum B7-H3 and IL-18 levels were detected by ELISA,and their correlation was analyzed by linear correlation. Results Serum B7-H3 level in 80 patients with decompensated liver cirrhosis was（62.29±22.17） ng/ml,significantly higher than（32.27±10.29） ng/ml（P<0.05） in 33 patients with compensated liver cirrhosis or than（11.35±4.48） ng/ml（P<0.05） in 20 healthy persons,and serum B7-H3 level in patients with compensated liver cirrhosis was also significantly higher than in healthy control（P<0.05）;serum IL-18 level in decompensated cirrhotics was （585.63±121.28） pg/ml,much higher than （396.29±86.91） pg/ml（P<0.05） in compensated liver cirrhosis or （155.31±76.93） pg/ml （P<0.05） in healthy persons,and serum IL-18 level in patients with compensated cirrhosis was also significantly higher than in healthy control （P<0.05）;serum B7-H3 level in patients with liver cirrhosis was positively correlated to serum IL-18 level （r=0.4111,P<0.01）;serum B7-H3 level in 26 patients with Child-Pugh class C was（76.53±22.76） ng/ml,significantly higher than（23.27±9.84） ng/ml in 33 patients with Child-Pugh class A or （52.21±13.94） ng/ml （P<0. 05） in 54 patients with Child-Pugh class B,and serum IL-18 level in patients with Child-Pugh class C was（594.13±112.21） pg/ml,significantly higher than （408.06±92.41） pg/ml in patients with Child-Pugh class B or （243.82±57.03） pg/ml（P<0.05） in patients with Child-Pugh class A,and serum IL-18 level in patients with Child-Pugh class B was also significantly higher than in patients with Child-Pugh class A（P<0.05）. Conclusion Serum B7-H3 level in patients with hepatitis B-induced liver cirrhosis increase accompanying with serum IL-18 level elevation,which might take part in the pathogenesis of liver cirrhosis.