慢性乙型肝炎患者血清中IL-17A和TGF-β1水平的变化及意义

The Changes and Significance of IL-17A and TGF-β1 Level in the Serum of Patients with Chronic Hepatitis B

目的:分析慢性乙型肝炎(CHB)患者血清中白细胞介素17A(IL-17A)及转化生长因子β1(TGF-β1)水平与肝脏损伤及乙肝病毒(HBV)复制的关系。方法:100例CHB患者(观察组),按病情程度分为轻、中、重度3组,按HBe Ag检测结果分为HBe Ag阳性组和HBe Ag阴性组,选择同期32例健康体检者作为对照组,于入院或体检时抽取空腹静脉血,采用酶联免疫吸附法(ELISA)检测血清IL-17A、TGF-β1水平,观察各分组及对照组血清IL-17A、TGF-β1水平,Spearman分析IL-17A、TGF-β1与血清丙氨酸氨基转移酶(ALT)、门冬氨酸转移酶(AST)、总胆红素(TBi L)、白蛋白(A)、HBV-DNA的相关性,分析IL-17A与TGF-β1两者的相关性。结果:CHB轻、中、重度组血清IL-17A及TGF-β1水平高于对照组(P<0.05),CHB轻、中、重度组患者随病情加重,血清IL-17A及TGF-β1水平逐渐升高,差异有统计学意义(P<0.05),HBe Ag阳性组与阴性组的血清IL-17A及TGF-β1水平比较,差异无统计学意义(P>0.05);血清IL-17A、TGF-β1水平与血清ALT、AST、TBi L呈正相关,与血清A呈负相关,血清IL-17A、TGF-β1水平与HBV-DNA无相关性,血清IL-17A水平与TGF-β1水平呈正相关。结论:IL-17A、TGF-β1可能参与了CHB患者肝脏的损伤及疾病的进展,但可能与HBV复制无关,联合检测IL-17A、TGF-β1对CHB患者的病情判断及预后有参考价值。

Objective： To investigate the changes and relationship of interleukin-17 A and transforming growth factor-β1 with liver damage and replication of hepatitis B virus in patients of chronic hepatitis B（ CHB）. Methods： Among 100 cases of CHB patients（ observation group）,there were light,moderate and severe groups according to illness degree. There were HBe Ag positive and negative group according to HBe Ag testing result. 32 cases of healthy persons as control group in the same time,fasting blood samples were collected at admission or physical examination with adopting ELISA to test the levels of serum IL-17 A and TGF-β1. Observing the levels of serum IL-17 A and TGF-β1 in observation group and control group,Spearman was used to analyz the relation of serum IL-17 A and TGF-β1 with ALT（ glutamate pyruvic transaminase）,AST（ aspartate transaminase）,TBil（ total bilirubin）,A（ albumin）,HBV-DNA,and the correlation between IL-17 A and TGF-β1. Results： The serum levels of IL-17 A and TGF-β1 in each group of CHB were higher than the control group（ P〈0. 05）. With the CHBpatient＇s condition in each group worsened,the serum level of IL-17 A and TGF-β1 was rising and the difference among groups was statistically significant（ P〈0. 05）. The difference of serum levels of IL-17 A and TGF-β1 between HBe Ag positive group and negative group was not statistically significant（ P〈0. 05）. The serum levels of IL-17 A and TGF-β1 were positively related with the serum levels of ALT,AST and TBiL（ r was 0. 849,0. 852,0. 570,P〈0. 001; r was 0. 536,0. 675,0. 582,P〈0. 001）,while they were negatively correlated with serum level of A（ r =-0. 522,P〈0. 001;r =-0. 616,P〈0. 001）. There was no correlation between serum levels of IL-17 A and TGF-β1 with HBV-DNA（ r = 0. 016,P = 0. 871; r = 0. 016,P = 0. 871）. The serum level of IL-17 A was positively correlated with TGF-β1（ r = 0. 786,P = 0. 000）. Conclusion： IL-17 A and TGF-β1 might be involved in liver damage and disease progression in CHB patients,but may not be correlated with HBV replication. Combined detection of IL-17 A and TGF-β1 has a reference value for the condition judgment and prognosis of CHB patients.