重型乙型肝炎血清白细胞介素-15水平检测及临床意义

目的 观察重型乙型肝炎患者血清白细胞介素-15(IL-15)水平的变化,探讨其在重型肝炎发病机制中的可能作用及临床意义.方法 采用双抗体夹心酶联免疫吸附试验检测47例重型乙型肝炎和20例健康者血清IL-15水平,同期检测血清丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)、凝血酶原活动度(PTA)等,分析重型乙型肝炎患者血清IL-15水平与ALT、TBIL、PTA等的相关性.结果 重型乙型肝炎组血清IL-15为(18.9±7.5)ng/L,显著高于正常对照组(5.9±2.0)ng/L(P<0.01);死亡组血清IL-15为(24.1±7.5)ng/L,显著高于存活组(15.7±5.4)ng/L(P<0.01);存活组患者血清IL-15浓度随一般情况好转、肝功能恢复而下降.此外,重型乙型肝炎组IL-15与TBIL呈正相关(r=0.570,P<0.01),与PTA呈负相关(r=-0.529,P<0.01),与ALT则无显著相关性(r=0.099,P>0.05).结论 IL-15可能参与重型乙型肝炎的发病过程.IL-15水平与病情存在一定程度的一致性,与病情的转归密切相关.血清IL-15水平的检测可能对于重型乙型肝炎患者的预后具有预测作用.

Clinical significance of serum interleukin-15 in the patients of severe type B hepatitis

Objective To observe the level changes of interleukin-15 (IL-15) and its role and clinical sig-nificance in severe type B hepatitis(HB). Methods IL-15 levels of 47 cases of severe HB and 20 cases of healthy subjects were detected by ELISA,meanwhile the alanine aminotransferase (ALT),total bilirubin (TBIL) and pro-thrombase activity (PTA) were measured as well. The correlation between IL-15 and ALT,TBIL and PTA were ana-lyzed. Results IL-15 in severe HB eases were higher than in control group (18.9±7.5 ) ng/L vs. (5.9±2.0) ng/L,P <0.01] ,which was higher in death group than in survival group(24.1±7.5) ng/L vs. (15.7±5.4) ng/L, P<0.01]. IL-15 level was decreasing with the improvement of general condition and liver function recovery. In addition, IL-15 in severe HB was positively correlated with TBIL (r=0.570,P<0.01) and negatively correlated with PTA(r=-0.529,P<0.01) but was not significantly correlated with ALT(r=0.099,P>0.05). Conclusion IL-15 may take part in the pathogenesis of severe HB ,which is consistent with disease condition and is closely re-lated to the improvement of disease. The detection of IL-15 may exert a predicting role in the prognosis of severe HB.