肝硬化病人血清IL-10、IL-18水平变化的临床意义

Clinic Significance of Change of Serum Levels of Interleukin 10 and Interleukin 18 in Patients with Liver Cirrhosis and

目的探讨血清白细胞介素10（IL-10）、血清白细胞介素18（IL-18）在肝炎后肝硬化发病机制中的作用。方法采用ELISA法检测103例肝炎肝硬化病人和20例健康献血员血清IL-10、IL-18的水平，观察肝功能child-pugh分级、腹水、血清白蛋白和血清总胆红素水平与血清IL-10、IL-18水平之间的关系。结果肝功能child-pughA、B、C级组血清IL-18水平均明显高于对照组（P〈0．01），肝功能child-pughA级组血清IL-10水平略高于对照组，但无显著性差异（P〉0．05）；肝功能child-pughB、C级组明显低于对照组（P〈0．05）；有腹水组、无腹水组血清IL-18水平均明显高于对照组（P均〈0．01），有腹水组血清IL-10水平明显低于无腹水组、对照组（P〈0．05，P〈0．01）；血清IL-10水平与血清IL-18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IL-18水平呈负相关（r=-0．315，P〈0．01）；血清总胆红素水平与血清IL-18水平呈正相关（r=0．677，P〈0．01），与血清几-10水平呈负相关（r=-0．339，P〈0．01）。结论IL-10、IL-18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） and intefluldn-18 （IL-18） levels and pathogenesis in patients with liver cirrhosis. Methods The serum levels of IL-10 and IL-18 were determined by ELISA respectively in 103 patients with liver cirrhosis and 20 controls. Results 1. The levels of IL-18 in groups A, B and C were all significantly higher than those in controls and increased with worsening of child score （P〈0.01）; The levels of IL-10 in group A were little 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 were inversely correlated with IL-18 （r=-0.51, P〈0.01）. Conclusion IL-18 and IL-10 may involve in the pathogenetic process of liver cirrhosis and have significant correlations. The levels of IL-18, IL-10 reflect degree of hepatocyte damage to some extent.