肝硬化相关肝性脑病患者血清中IL-6、IL-18与血氨水平的相关性分析

  目的  对肝硬化相关肝性脑病(HE)患者临床资料进行收集，回顾性分析HE患者血清白细胞介素6(IL-6)、白细胞介素18(IL-18)水平与血氨水平的相关性。  方法  选取2019年6月—2021年1月河南省荣军医院住院治疗的肝硬化患者95例，其中单纯肝硬化患者41例设为非HE组，肝硬化合并HE患者54例设为HE组，另选同期该院体检健康人员50例，设为健康组。比较3组患者的血氨水平及血清IL-6、IL-18水平；比较HE组与非HE组临床资料的差异，并采用logistic回归分析法分析HE的危险因素；采用Pearson相关性分析法分析血氨水平与血清中IL-6、IL-18水平的相关性。  结果  与健康组比较，非HE组、HE组血清IL-6、IL-18水平及血氨水平均升高(均P＜0.05)；HE组血清IL-6、IL-18水平及血氨水平高于非HE组(均P＜0.05)；logistic回归分析显示，血清IL-6、IL-18、总胆红素(TBIL)高，凝血酶原时间(PT)长是肝硬化相关HE的危险因素(均P＜0.05)；Pearson相关性分析显示，血清IL-6与血氨水平呈正相关(r=0.690，P＜0.001，95% CI:0.518~0.808)，IL-18与血氨水平呈正相关(r=0.667，P＜0.001，95% CI:0.487~0.793)。  结论  血清IL-6、IL-18、TBIL高，PT长均是肝硬化相关HE发生的危险因素，且血清IL-6、IL-18水平与血氨水平均呈正相关。 

Correlation analysis of serum IL-6, IL-18 and blood ammonia level in patients with hepatic encephalopathy

  Objective  The clinical data of patients with liver cirrhosis-related hepatic encephalopathy (HE) were collected, and the correlation among serum interleukin-6 (IL-6), interleukin-18 (IL-18) and blood ammonia levels in patients with HE was analysed retrospectively.  Methods  A total of 95 patients with liver cirrhosis were selected in Rongjun Hospital of Henan province from June 2019 to January 2021. Among them, 41 patients with simple liver cirrhosis were set as non-HE group, and 54 patients with liver cirrhosis and HE were set as HE group. Another 50 healthy persons from our hospital were selected as the health group in the same period. The levels of serum ammonia, IL-6 and IL-18 were compared among the three groups. Differences in the clinical data between HE and non-HE groups were compared, and the risk factors of HE were determined by logistic regression analysis. Pearson correlation analysis was used to evaluate the correlation among serum levels of ammonia, IL-6 and IL-18.  Results  The levels of serum IL-6, IL-18 and blood ammonia in the non-HE and HE groups were higher than those in the healthy group (P < 0.05). The levels of serum IL-6, IL-18 and blood ammonia in the HE group were higher than those in non-HE group (P < 0.05). Logistic regression analysis showed that high serum levels of IL-6, IL-18, total bilirubin (TBIL) and long prothrombin time (PT) were risk factors for cirrhosis-related HE (P < 0.05). Pearson correlation analysis showed that serum IL-6 was positively correlated with serum ammonia level (r=0.690, P < 0.001, 95% CI: 0.518-0.808), and IL-18 was positively correlated with blood ammonia level (r=0.667, P < 0.001, 95% CI: 0.487-0.793).  Conclusion  High serum levels of IL-6, IL-18, TBIL and long PT are risk factors for hepatocirrhosis-related HE, and serum IL-6 and IL-18 levels are positively correlated with the average level of blood ammonia.