肝炎肝硬化患者血清IL-10、IL-18水平的变化及意义

Serum Levels of Interleukin 10 and Interleukin 18 in Patients with Posthepatitic Cirrhosis and Their Clinic Sgnificance

目的探讨血清IL10、IL18在肝炎肝硬化的发病机制中的作用。方法62例肝炎肝硬化患者根据childpugh分级法分为3组:childpughA级组19例、childpughB级组23例和childpughC级组20例。采用ELISA法检测3组患者和20例健康献血员血清IL10、IL18的水平。结果childpughA、B、C级组血清IL18水平均明显高于对照组(P均<0.01),childpughA级组血清IL10水平略高于对照组,但无显著性差异(P>0.05);childpughB、C级组明显低于对照组(P<0.05);有腹水组、无腹水组血清IL18水平均明显高于对照组(P均<0.01),有腹水组血清IL10水平明显低于无腹水组、对照组(P<0.05,P<0.01);血清IL10水平与血清IL8水平呈负相关(r=-0.51,P<0.01);血清白蛋白水平与血清IL10水平呈正相关(r=0.566,P<0.01),与血清IL8水平呈负相关(r=-0.315,P<0.01);血清凝血酶原活动度与血清IL10水平呈正相关(r=0.506,P<0.01),与血清IL18水平呈负相关(r=-0.463,P<0.01);血清总胆红素水平与血清IL8水平呈正相关(r=0.677,P<0.01),与血清IL10水平呈负相关(r=-0.339,P<0.01)。结论IL10、IL18在肝炎肝硬化的发病机制中起一定的作用,其水平与肝损害程度密切相关。

Objective To explore the relationship between serum interlukin-10(IL-10)、interlukin-18(IL-18)levels and pathogenesis in patients with posthepatitic cirrhosis.Methods The serum levels of IL-10 and IL-18 were detected by ELISA respectively in 62 patients with post-hepatitic cirrhosis and 20 controls.The 62 patients were divided into three groups as A,B and C according the Child-pugh scores.Results 1.The levels of IL-18 in groups A、B、C were all higher than those in controls and increased with worsening of child score(P<0.01);The levels of IL-10 in group A were littele higher than those in controls(P>0.05),but significantly higher in group A than those in groups B and C (P<0.05～0.01),the levels in C groups were much lower than those in B groups(P<0.01).2.patients with ascites had higher levels of IL-18 than patients without ascites (P<0.05),however,had lower levels of IL-10.3 The levels of IL-10 in patient were correlated with PTA and albumin concentrations and inversely correlated with serum bilirubin concentrations.The levels of IL-18 in patiens were correlated with serum bilirubin concentrations and inversely correlated with PTA and albumin.4 The levels of IL-10 were inverslycorrelated with IL-18(R=-0.51,P<0.01).Conclusion IL-18 and IL-10 may involve in the pathogenetic process of post-hepatitic cirrosis and have significant correlations.The levels of IL-18、IL-10 reflect degree of hepatocyte damage to some extent.