乙型肝炎肝硬化患者血清可溶性细胞间黏附分子-1、白细胞介素-18测定及临床意义

Detection of serum soluble intercellular adhesion molecule-1 and interleukin-18 in patients with hepatitis B cirrhosis and their clinical significance

目的:探讨乙型肝炎肝硬化患者血清可溶性细胞间黏附分子-1(soluble intercellular adhesion molecule-1,sICAM-1)、白细胞介素(interleukin,IL)-18的变化及其临床意义。方法:采用ELIAS法对60例乙型肝炎肝硬化患者(肝硬化组)和30例健康体检者(对照组)血清sICAM-1、IL-18水平进行检测。结果:肝硬化组血清sICAM-1,IL-18水平高于对照组(P<0.01)。肝硬化Child C级组血清sICAM-1,IL-18水平高于Child A级组和B级组,Child B级组高于Child A级组,差异均有统计学意义(P<0.01)。肝硬化组血清sICAM-1,IL-18水平与凝血酶原活动度、白蛋白呈负相关,与总胆红素呈正相关,与丙氨酸转氨酶无相关性。血清sICAM-1水平与IL-18呈正相关。结论:sICAM-1,IL-18水平在一定程度上反映肝细胞损伤程度和肝硬化严重程度,可为临床诊治、评判预后提供依据。

Objective To investigate the changes and the clinical significance of serum soluble intercellular adhesion molecule-1 and interleukin-18 in patients with hepatitis B cirrhosis.Methods The serum levels of soluble intercellular adhesion molecule-1 and interleukin-18 were detected with ELISA in 60 patients with hepatitis B cirrhosis and 30 normal controls.Results The serum levels of soluble intercellular adhesion molecule-1 and interleukin-18 in patients with hepatitis B cirrhosis were significantly higher than those in normal controls（P0.01）.The serum levels of soluble intercellular adhesion molecule-1 and interleukin-18 were significantly higher in Child-Pugh C cirrhosis group than those in Child-Pugh A cirrhosis group and Child-Pugh B cirrhosis group,and were higher in Child-Pugh B cirrhosis group than those in Child-Pugh A cirrhosis group,which showed significant differences（P0.01）.The levels of soluble intercellular adhesion molecule-1 and interleukin-18 in patients with hepatitis B cirrhosis were negatively correlated to prothrombin activity and albumin,positively correlatied with total bilirubin,and were not correlated to alanine transarninase.The serum soluble intercellular adhesion molecule-1 level was positively correlated to interleukin-18.Conclusion The levels of soluble intercellular adhesion molecule-1 and interleukin-18 can reflect the degree of hepatocyte damage and the severity of hepatitis B cirrhosis,which provides the basis for the diagnosis,therapy and prognosis.