自身免疫性肝炎患者血清趋化因子水平与生物化学指标的相关性

Investigate circulating levels of chemokines and evaluate the correlation between these chemokines and liver function indicators in autoimmune hepatitis

目的探讨自身免疫性肝炎（AIH）患者外周血中趋化因子（CCL2、CCL5、CXCL8、CXCL9和CXCL10）水平及其与肝脏生物化学指标的相关陆。方法检测46例AIH患者血清中趋化因子（CCL2、CCL5、CXCL8、CXCL9和CXCL10）水平，选择12例健康体检者为对照组。结果AIH组CCL2、CXCL9和CXCL10水平分别为11．79pg／ml、11．31pg／ml和15．85pg／ml，高于健康对照组的8．39pg／ml、2．69pg／ml、4．64pg／ml，两组比较，z值分别为-1．958、4．527、-3．84，P值均〈0．05，差异均有统计学意义。AIH活动期组血清CCL2、CXCL8、CXCL9和CXCL10水平分别为29．69pg／ml、7．2pg／ml、16．02pg／ml和90．01pg／ml，明显高于激素治疗后缓解期组的11．16pg／ml、5．38pg／ml、5．47pg／ml、13．24pg／ml，两组比较，统计值分别为t=2．985、z=-2．547、z=-3．187、t=2．12，P值均〈0．05，差异均有统计学意义。AIH患者血清CXCL8与IgG水平呈正相关关系（r2=0．291，P〈0．05）；CXCL9与ALT、AST水平均呈正相关关系（r2值分别为0．5324、0．3352，P值均〈0．05）；CXCL10与ALT、AST、GGT水平均呈正相关关系（r2值分别为0．9551、0．8960、0．8271，P值均〈0．05）。结论活动期AIH患者外周血中CCL2、CXCL8、CXCL9和CXCL10水平明显升高，CXCL9和CXCL10水平与肝脏炎症活动指标呈明显正相关关系，提示趋化因子水平可反映AIH肝脏炎症活动程度，在AIH病理损伤中发挥重要作用。

Objective This study investigated circulation levels of chemokines （CCL2, CCL5, CXCL8, CXCL9, CXCL10） in autoimmune hepatitis（AIH） patients and evaluated the correlation between these chemokines and liver function indicators. Methods A total of 5 chemokines （CCL2, CCL5, CXCL8, CXCLg, CXCL10） were measured simultaneously by cytokine beads assay（CBA） in the sera of 46 patients with AIH and 12 cases of healthy control. Results In this study we found that serum levels of CCL2, CXCL9 and CXCL 10 in AIH patients and healthy controls were 11.79：8.39 pg/ml, 11.31：2.69 pg/ml, 15.85：4.64 pg/ ml, respectively, which implied these chemokines were significantly higher in AIH patients when compared to healthy control （Z=-1.958, P= 0.05; Z= -4.527, P 〈 0.0001; Z=-3.84, P 〈 0.0001, respectively）. And circulation levels of CCL2, CXCL8, CXCL9 and CXCL10 in pretreatment and remission stages of patients with AIH were 29.69：11.16 pg/ml, 7.2：5.38 pg/ml, 16.02：5.47 pg/ml, 90.01：13.24 pg/ml, respectively, which showed these chemokines decreased during remission from pretreatment stage levels （t = 2.985, P = 0.005;Z= -2.547, P = 0.0112; Z= -3.187, P = 0.001; t = 2.12, P = 0.0015, respectively）. Among AIH, CXCL8 was correlated positively with lgG（r2 = 0.291, P = 0.0039）; CXCL9 was associated positively with ALT and AST（r2 = 0.5324, P 〈 0.0001; r2 = 0.3352, P 〈 0.0001）; CXCL10 showed a positive correlation with ALT, AST and GGT（r2 = 0.9551,P〈 0.0001;r2 = 0.8960,P〈 0.0001;r2 = 0.8271,P 〈 0.0001）. Conclusion Serum levels of CCL2, CXCL8, CXCL9 and CXCL10 are significantly higher in patients with AIH, but decrease to levels in healthy controls after successful treatment, and circulation levels of CXCL9 and CXCL10 are associated positively with liver function indicators which can react inflammation activity of liver, all these may imply that chemokines can reflect the degree of liver inflammation and may be one of the main culprits in AIH pathological damage.