有偿献血人群血浆IL-18水平与HCV感染及其基因型的相关性研究

A study on correlation of IL-18 level with HCV infection and viral genotyping in paid blood donors

目的了解有偿献血人群血浆白细胞介素18（interleukin-18,IL-18）水平与丙型肝炎病毒（hepatitis C virus,HCV）感染结局、肝功能指标及HCV基因型的关系,探讨IL-18在HCV感染及慢性化中的作用。方法以2012年4~7月在江苏某地区收集的150例既往有偿献血者为研究对象,根据抗-HCV抗体和HCV RNA的检测结果将其分为健康对照、自限清除和持续感染者三组人群,并采用酶联免疫吸附测定法检测其血浆IL-18水平,分析其在三组间的差异及其与各项肝功能指标、HCV基因型的关系。结果献全血次数、丙氨酸氨基转移酶（alanine aminotransferase,ALT）、天门冬氨酸氨基转移酶（aspartate aminotransferase,AST）、单采血浆次数,谷酰转肽酶、总蛋白和IL-8水平在三组间的差异均有统计学意义（均有P〈0.05）。以年龄、性别、献全血次数、脂肪肝和/或肝硬化作为协变量的协方差分析结果显示,血浆IL-18水平、ALT和AST水平在三组间的差异均有统计学意义（均有P〈0.05）。血浆IL-18水平在三组不同HCV基因型人群（HCV1b型、非1b型和混合型）中的差异有统计学意义（H=8.64,P=0.013）。以年龄、性别、献全血次数、单采血浆次数、脂肪肝和/或肝硬化作为控制变量的偏回归分析结果显示,IL-18与ALT、AST水平呈正相关关系（r1=0.279,P1=0.022;r2=0.302,P2=0.013）。结论血浆IL-18可能影响HCV感染及其慢性化进程,在参与HCV清除的同时亦会造成肝细胞损伤。血浆IL-18水平的不同可能是HCV不同基因型感染者慢性化进程存在差异的原因之一。

Objective To investigate the correlation of sera IL-18 level with HCV infection,HCV genotyping,and liver function in paid blood donors,and to explore the role of IL-18 level in the development and progression of HCV infection. Methods The study population were consisted of 150 subjects who were enrolled in Jiangsu province from April to July 2012. All participants were categorized into three groups,including 50 healthy controls,50 natural clearance subjects and 50 persistent HCV carriers. The IL-18 concentration was measured by enzyme linked immunosorbent assay（ ELISA）.Covariance analysis and partial correlation were used to evaluate the associations of plasma IL-18 level with outcomes of HCV infection and liver function. Results The number of whole blood donation and plasma donation,the level of ALT,AST,GGT,TP and IL-18 showed statistical significant differences among the three groups（ all P〈 0. 05）. Controlling for the age,sex,liver disease（ fatty liver and /or cirrhosis）,the number of whole blood donation and plasma donation,the IL-18,ALT and AST levels showed statistical significant differences among the three groups（ all P〈 0. 05）. Moreover,the difference of the IL-18 concentration among patients with different HCV genotypes（ 1b,non-1b,and mixed type） was statistically significant（ H = 8. 64,P = 0. 013）. The partial correlation analysis indicated that the level of IL-18 was positively correlated with ALT and AST（ r1= 0. 279,P1= 0. 022; r2= 0. 302,P2= 0. 013）. Conclusions The sera IL-18 level may play an vital role in the development and pathogenesis of HCV infection. Different IL-18 levels among individuals with different HCV genotypes could partly explain the disparity of HCV infection outcomes.