慢性重型肝炎患者血清IL-18、IL-12和IFN-γ的表达及人工肝治疗

Expressions of IL-18,IL-12 and IFN-γ in chronic severe hepatitis patients and treatment with artificial liver support system

目的探讨慢性重型肝炎(CSH)患者外周血白细胞介素18(IL-18)、IL-12和γ干扰素(IFN-γ)的表达及人工肝治疗对IL-18等细胞因子的影响。方法运用双抗体夹心酶联免疫吸附法(ELISA)检测148例慢性乙肝病毒感染者和20例健康体检者及28例CSH患者人工肝(ALSS)治疗后血清的IL-18、IL-12、IFN-γ,同时检测血清ALT、TBil、凝血酶原活动度(PTA),并观察对并发症的疗效。结果CSH患者IL-18、IL-12、IFN-γ明显高于常人(P<0.01)。其在ALSS治疗前为(819.1±334.3)、(661.9±284.9)和(341.9±152.2)pg/ml,治疗后明显降低为(778.3±320.1)、(614.9±264.90)和(325.7±153.5)pg/ml(P<0.01)。IL-18与IL-12、IFN-γ呈正相关。ALSS治疗对PTA的升高以及肝功能、肝性脑病意识转清的恢复有明显疗效。结论IL-18、IL-12、IFN-γ可能参与了肝脏的慢性炎性损伤过程,与重型肝炎发生具有相关性;ALSS联合内科治疗能有效降低CSH患者IL-18、IL-12、IFN-γ。

Objective To investigate the expressions of serum interleukin（IL）-18,IL-12 and interferon factor（IFN）-γ in patients with chronic severe hepatitis （CSH） and the effect of treatment interferon factor artificial liver support system（ALSS） on them.Methods Serum IL-18,IL-12 and IFN-γ levels were determined by ELISA method in 148 CSH cases and 20 healthy people.ALT,TBil and PTA were determined before and after ALSS treatment.Complications were observed. Results Serum IL-18,IL-12 and IFN-γ levels in CSH were significantly higher than those in the healthy controls（P〈0.01）.The expressions of IL-18,IL-12 and IFN-γ after ALSS treatment were （778.3±320.1）,（614.9±264.9） and （325.7±153.5）pg/ml,which were significantly lower than （819.1±334.3）,（661.9±284.9） and （341.9±152.2）pg/ml before （P〈0.01）.There was a close positive correlation between IL-18 and IL-12,IFN-γ.ALSS treatment had obvious effect in the increase of PTA and recovery of liver function and hepatic coma.Conclusion IL-18,IL-12 and IFN-γ may participate in liver inflammatory injury prosess and have relevence with CSH. ALSS treatment can effectively decrease serum IL-18,IL-12 and IFN-γ level.