慢加急性乙型肝炎肝功能衰竭患者肝功能及血炎性因子与脂氧素A4变化的相关性研究

Correlation between liver function,serum inflammatory factors,and lipoxin A4 in patients with acute-on-chronic hepatitis B liver failure

目的探讨慢加急性乙型肝炎肝功能衰竭患者(ACHBLF)肝功能、血炎性因子与脂氧素A4变化及相关性,分析其在ACHBLF发病中可能所起的作用,为ACHBLF的临床诊治提供参考。方法选取2014年1月-2015年10月在医院诊治的ACHBLF(ACHBLF组)与慢性乙型肝炎(CHB组)患者各50例,检测白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、脂氧素A4(LXA4)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBil)。结果 ACHBLF组ALT、AST、TBil、IL-6、TNF-α水平为(241.73±83.65)U/L、(200.51±75.13)U/L、(323.64±84.52)μmol/L、(50.77±8.32)pg/ml、(17.60±1.50)pg/ml,均高于CHB组,LXA4为(8.95±2.31)μg/L低于CHB组,差异有统计学意义(P<0.05);ACHBLF组重度患者ALT、AST、TBil、IL-6、TNF-α水平为(287.93±85.88)U/L、(246.97±80.51)U/L、(385.34±83.43)μmol/L、(67.84±6.53)pg/ml、(24.55±2.22)pg/ml,均高于轻中度患者,LXA4为(7.12±2.03)μg/L低于轻中度患者,差异有统计学意义(P<0.05);ACHBLF组患者ALT、AST、TBil、IL-6、TNF-α水平均与LXA4水平呈现负相关(P<0.05)。结论 ACHBLF患者炎性因子可能参与了病情的发生及发展,肝功能、炎性因子与LXA4水平呈现负相关,检测以上指标变化可有助于判断病情严重程度。

OBJECTIVE To explore the correlation between liver function,serum inflammatory factors,and lipoxin A4 in patients with acute-on-chronic hepatitis B liver failure（ACHBLF）and analyze the influence on pathogenesis of ACHBLF so as to provide guidance for clinical diagnosis and treatment of ACHBLF.METHODS Totally 50 patients with ACHBLF（the ACHBLF group）and 50 patients with chronic hepatitis B（the CHB group）who were treated in hospitals from Jan 2014 to Oct 2015 were enrolled in the study.The levels of interleukin-6（IL-6）,tumor necrosis factorα（TNF-α）,lipoxin A4（LXA4）,alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,and total bilirubin（TBil）were detected.RESULTS The levels of ALT,AST,TBil,IL-6,and TNF-αof the ACHBLF group were respectively（241.73±83.65）U/L,（200.51±75.13）U/L,（323.64±84.52）μmol/L,（50.77±8.32）pg/ml,and（17.60±1.50）pg/ml,higher than those of the CHB group;the level of LXA4 of the ACHBLF group was（8.95±2.31）μg/L,lower than that of the CHB group（P〈0.05）.The levels of ALT,AST,TBil,IL-6,and TNF-αof the patients with severe ACHBLF were respectively（287.93±85.88）U/L,（246.97±80.51）U/L,（385.34±83.43）μmol/L,（67.84±6.53）pg/ml,and（24.55±2.22）pg/ml,higher than those of the patients with mild and moderate ACHBLF;the level of LXA4 of the patients with severe ACHBLF was（7.12±2.03）μg/L,lower than that of the patients with mild and moderate ACHBLF（P〈0.05）.The levels of ALT,AST,TBil,IL-6,and TNF-αof the patients with ACHBLF were negatively correlated with the level of LXA4（P〈0.05）.CONCLUSIONThe inflammatory factors may involve in the occurrence and development of ACHBLF.The liver function and inflammatory factors are negatively correlated with the level of LXA4.The detection of the above indicators may facilitate the judgment of severity of illness condition.