IL-35及IFN-γ与HBV慢性感染后肝损伤程度的关系研究

Study on the relationship between IL-35 and IFN-γ and the degree of liver injury after chronic hepatitis B virus infection

目的探讨白细胞介素-35(IL-35)及γ-干扰素(IFN-γ)与乙型肝炎病毒(HBV)慢性感染后肝损伤程度的关系。方法选取2014年2月-2018年1月于医院诊断治疗的不同类型HBV慢性感染患者124例为研究对象,依据病情严重程度不同,将患者分为原发性肝癌(PHC)组28例、乙型肝硬化(LC)组30例、慢性乙型肝炎(CHB)组32例以及慢性HBV携带者(ASC)组34例。选择同期于医院健康体检,且经检查肝功各项指标均正常者30例为对照组。采用酶联免疫吸附法测定并对比所有研究对象IL-35和IFN-γ水平;使用全自动生化分析仪检测所有研究对象肝功能状态;采用聚合酶链反应检测并比较不同类型HBV慢性感染者HBV-DNA水平变化;分析肝功能各项指标与IL-35、IFN-γ相关性。结果 PHC组IL-35水平为(1198.59±331.45)pg/mL、IFN-γ水平为(689.54±117.13)pg/mL,LC组分别为(823.41±79.36)pg/mL、(680.98±115.41)pg/mL,CHB组分别为(540.93±22.37)pg/mL、(679.83±117.91)pg/mL,ASC组分别为(105.22±19.59)pg/mL、(669.97±120.33)pg/mL,PHC组、LC组、CHB组及ASC组IL-35、IFN-γ水平均高于对照组(P<0.05);PHC组IL-35水平高于LC组、CHB组及ASC组(P<0.05);PHC组、LC组、CHB组及ASC组AST、ALT及TBil肝功能各项指标水平均高于对照组(P<0.05);CHB组肝功能各项指标水平均高于PHC组、LC组及ASC组(P<0.05);HBV-DNA阴性、低载量、中载量及高载量患者IL-35、IFN-γ水平均高于对照组(P<0.05);HBV-DNA高载量患者IL-35水平高于HBV-DNA阴性、低载量、中载量患者,IFN-γ水平低于HBV-DNA阴性、低载量、中载量患者(P<0.05);经Spearman法分析,结果显示IL-35与AST、ALT、TBil水平无相关性,IFN-γ与AST、ALT、TBil水平亦无相关性。结论 IL-35和IFN-γ可能参与HBV慢性感染病情进展,并与肝损伤程度有一定关系。

OBJECTIVE To investigate the relationship between IL-35 and IFN-γand the degree of liver injury after chronic hepatitis B virus infection.METHODS A total of 124 patients with different types of HBV chronic infections diagnosed and treated in our hospital from Feb.2014 to Jan.2018 were selected as the research subjects.According to the severity of the disease,the patients were divided into PHC group（28 cases）,LC group（30 cases）,CHB group（32 cases）and ASC group（34 cases）.30 cases of healthy people with normal liver function indexes were selected as the control group at the same time.Enzyme-linked immunosorbent assay was used to determine and compare the levels of IL-35 and IFN-γin all the people.The full automatic biochemical analyzer was used to detect the liver function status of all the people who entered the group.Polymerase chain reaction was used to detect and compare the changes of HBV-DNA levels in patients with different types of hepatitis B virus.The correlations between various indexes of liver function and IL-35 and IFN-γwere analyzed.RESULTS The level of IL-35 in group PHC was（1198.59 ＋ 331.45）pg/mL and the IFN-IFN-level was（689.54±117.13）pg/mL.The IL-35 and IFN-IFN-levels in Group LC were（823.41±79.36）pg/mL and（680.98±115.41）pg/mL,respectively.The IL-35 and IFN-IFN-levels in group CHB were（540.93±22.37）pg/mL and（679.83±117.91）pg/mL,respectively.The IL-35 and IFN-IFN-levels in group ASC were（105.22±19.59）pg/mL and（669.97±120.33）pg/mL,respectively.The average values of IL-35 and IFN-γin group PHC,LC,CHB and ASC were significantly higher than those in the control group（P〈0.05）.The level of IL-35 in group PHC was significantly higher than that in group LC,group CHB and ASC group（P〈0.05）.There was no significantly difference in IFN-γlevel between group PHC,group LC,group CHB and group ASC.The levels of AST,ALT and TBil in liver function of PHC group,LC group,CHB group and ASC group were significantly higher than those of the control group,and the difference between the groups was statistically significant（P〈0.05）.The level of liver function in CHB group was significantly higher than that in group PHC,group LC and group ASC（P〈0.05）.The levels of IL-35 and IFN-γof HBV-DNA negative group,low load group,medium load group and high load group were significantly higher than those of the control group（P〈0.05）.The level of IL-35 in HBV-DNA high load group was significantly higher than that in HBV-DNA negative group,low load group and moderate load group.The level of IFN-γwas significantly lower than that in HBV-DNA negative group,low load group and moderate load group.The results of spearman analysis showed that there was no significant correlation between IL-35 and AST,ALT and TBil levels.There was no significant correlation between IFN-γ and AST,ALT and TBil levels.CONCLUSIONIL-35 and IFN-γmay be involved in the progression of chronic HBV infection and have a certain relationship with the degree of liver injury.