白细胞介素17A在慢性乙肝患者血清的表达

Expression of interleukin-17A in serum of patients with chronic hepatitis B and its clinical significance

目的:通过分析慢性乙型肝炎(CHB)患者血清中白细胞介素17A(IL-17A)的表达,旨在探索IL-17A与肝脏损伤、乙肝病毒(HBV)复制之间的关系。方法:(1)对101例CHB患者和33例健康者用酶联免疫吸附法(ELISA)检测血清中IL-17A水平;(2)所有研究对象HBV抗原抗体采用ELISA法检测;(3)所有研究对象肝功能采用全自动生化分析仪检测;(4)采用实时荧光定量聚合酶链反应(FQ-PCR)法检测CHB患者HBV-DNA。结果:(1)对照组、CHB轻度组、CHB中度组及CHB重度组之间血清IL-17A水平比较均有显著性差异(P<0.05),且对照组、轻度组、中度组、重度组依次逐渐升高;(2)HBe Ag阳性组与HBe Ag阴性组的血清IL-17A水平无显著性差异(P>0.05);(3)IL-17A与丙氨酸氨基转移酶(ALT)、天门冬氨酸转移酶(AST)、碱性磷酸酶(ALP)、谷氨酰转肽酶(γ-GT)、总胆汁酸(TBA)、总胆红素(TBIL)均呈正相关,相关系数r分别为0.816、0.762、0.181、0.509、0.345、0.403,P均<0.05;IL-17A与白蛋白(A)呈负相关(r=-0.194,P<0.05);(4)血清IL-17A水平与HBV-DNA水平正相关(r=0.204,P<0.05)。结论:(1)CHB患者血清中IL-17A水平升高,且随炎症程度加重、合成功能下降呈上升趋势,推测IL-17A可能参与了CHB患者肝脏受损和疾病进展;(2)IL-17A不能使e抗原发生血清学转换;(3)血清IL-17A的表达与HBV复制相关;(4)联合检测IL-17A和肝功能对CHB患者的病情、预后判断有参考价值。

Objective： To explore the relationships between IL-17 A and liver damage,hepatitis B virus（ HBV） replication by analyzing the expression of IL-17 A in serum of patients with chronic hepatitis B（ CHB）. Methods：（ 1） The serum level of IL-17 A was detected by ELISA in 101 CHB patients and 33 healthy controls;（ 2） HBV antigen-antibody was detected by ELISA in all research objects;（ 3） Hepatic function was detected by automatic biochemistry analysator in all research objects;（ 4） Real-time fluorescent quantitative PCR was used to measure HBV-DNA in CHB patients. Results：（ 1） There were significant differences in the serum level of IL-17 A between the control group,mild CHB group,moderate CHB group and severe CHB group（ P 〈 0. 05）,and it gradually increased in the control group,mild,moderate,and severe groups;（ 2） There was no significant difference in the serum level of IL-17 A between HBe Ag positive group and HBe Ag negative group（ P 〉 0. 05）;（ 3） IL-17 A was positively correlated with ALT,AST,ALP,γ-GT,TBA and TBIL; the correlation coefficient（ r） was 0. 816,0. 762,0. 181,0. 509,0. 345 and 0. 403,respectively（ all P 〈 0. 05）; IL-17 A was negatively correlated with albumin（ r =-0. 194,P 〈 0. 05）;（ 4） A significantly positive correlation was found between the serum level of IL-17 A and the level of HBV-DNA（ r = 0. 204,P 〈 0. 05）. Conclusion：（ 1） The serum level of IL-17 A increases in CHB patients,and it shows an upward trend with the aggravation of inflammation and the declined synthesis function,which suggests that IL-17 A might be involved in liver damage and disease progression in CHB patients;（ 2） IL-17 A can not contribute to the CHB patients with HBe Ag serological conversion;（ 3） The expression of serum IL-17 A is correlated with HBV replication;（ 4） The combined detection of IL-17 A and hepatic function has a reference value for the judgment of pathogenetic condition and prognosis in CHB patients.