肝移植术后血清可溶性白细胞介素-2受体和胆汁白细胞介素-6的监测及意义

Study on the inspection and significance of serum soluble interleukin-2 receptor and interleukin-6 level in bile after liver transplantation

目的 检测肝移植术后血清可溶性白细胞介素-2受体（sIL-2R）和胆汁白细胞介素-6（IL-6）的表达水平,探讨肝移植术后监测sIL-2R和IL-6的临床意义.方法 选取我院采用肝移植治疗的69例终末期肝病患者作为研究对象,根据术后是否发生急性排斥反应分为2组,即急性排斥反应组共36例和无排斥反应组共33例,应用酶联免疫吸附试验（ELISA）法检测患者的sIL-2R和IL-6水平,比较两组患者的表达差异.结果 移植术后第1d两组血清sIL-2R及胆汁IL-6表达水平差异无统计学意义（P＞0.05）;观察组排斥反应发作前48 h血清sIL-2R为（471.82 ±66.46） pmol/L,胆汁IL-6为（621.81±76.92） pmol/L,确诊时为血清sIL-2R为（721.96±68.53） pmol/L,胆汁IL-6为（858.71 ±89.52） pmol/L,显著高于对照组（P＜0.05）.经过激素冲击治疗后,血清sIL-2R及胆汁IL-6表达回落,与对照组差异无统计学意义（P＞0.05）.结论 sIL-2R及胆汁IL-6与肝移植术后急性排斥反应关系密切,有望成为诊断急性排斥反应及评价疗效的敏感性、特异性指标.

Objective To inspect the expression of serum soluble interleukin-2 receptor （sIL-2R） and interleukin-6 （IL-6） in bile after liver transplantation and to discuss clinical inspection significance of sIL-2R and IL-6 after liver transplantation.Methods From December 2012 to February 2014,we selected 69 patients with end-stage liver disease as research subjects after liver transplantation in our hospital.They were divided into 2 groups according to postoperative acute rejection,the patients with postoperative acute rejection group,n =36,none acute rejection group,n =33.The sIL-2R and IL-6 levels were detected by using sandwich enzyme-linked immunosorbent assay,the expression differences were compared between the two groups.Results There were no significant differences in the expressions of bile IL-6 and sIL-2R on the first day after transplantation （P 〉 0.05）;Serum sIL-2R was （471.82 ± 66.46） pmol/L and bile IL-6 was （621.81 ±76.92） pmol/L 48 hours before acute rejection in observation group.When they were diagnosed,the serum sIL-2R was （721.96 ±68.53） pmol/L and bile IL-6 was （858.71 ±89.52） pmol/L,they were significantly higher than the control group （P 〈0.05）.After steroid pulse therapy,the expressions of serum sIL-2R and bile IL-6 were decrease,there were no significant differences when compared with the control group （P 〉 0.05）.Conclusion There was close relationship between SIL-2R,bile IL-6 and acute rejection after liver transplantation.It was expected to be the sensitivity and specificity indexes in the diagnosis of acute rejection and evaluation of curative effect.