慢性乙型肝炎和肝硬化患者血清TLR4、TGF-β1和IL-17水平及其临床意义

Serum TLR4,TGF-β1 and IL-17 levels in patients with chronic hepatitis B and hepatitis B-induced liver cirrhosis

目的分析慢性乙型肝炎(CHB)和乙型肝炎肝硬化患者血清Toll样受体4(TLR4)、转化生长因子-β1(TGF-β1)和白细胞介素-17(IL-17)水平变化及其临床意义。方法 2015年6月~2017年4月本院收治的112例CHB、52例乙型肝炎肝硬化患者和选择的33例健康人,采用ELISA法检验血清IL-17、TLR4、TGF-β1水平,常规进行肝活检。结果慢性乙型肝炎、肝硬化和健康人血清IL-17水平分别为(264.42±32.53)pg/ml、(271.54±33.71)pg/ml和(64.18±5.52)ng/ml,血清TLR4水平分别为(5.81±0.83)pg/ml、(37.41±6.05)pg/ml和(1.07±0.13)ng/ml,血清TGF-β1水平分别为(3.67±0.42)pg/ml、(7.82±1.07)pg/ml和(1.61±0.07)ng/ml,差异明显(P<0.05);19例Child-Pugh B级血清IL-17、TLR4和TGF-β1水平分别为(231.38±28.67)pg/ml、(18.61±2.87)pg/ml和(5.76±0.52)ng/ml,16例C级患者分别为(301.72±32.72)pg/ml、(39.47±6.82)pg/ml和(9.42±1.27)ng/ml,均明显高于17例Child-Pugh A级患者【分别为(204.53±26.57)pg/ml、(4.72±0.71)pg/ml和(3.18±0.34)ng/ml,P<0.05】;肝活检组织学检查发现S0 8例、S1 42例、S2 43例、S3 19例、S4 52例,血清IL-17、TLR4、TGF-β1水平随着肝组织纤维化分期严重而升高。结论乙型肝炎肝硬化患者血清TLR4、TGF-β1和IL-17水平升高,对诊断和指导治疗可能有帮助。

Objective To investigate serum levels of Toll like receptor 4(TLR4),transforming growth factor beta 1(TGF-β1)and interleukin-17(IL-17)in patients with chronic hepatitis B(CHB)and hepatitis B-induced liver cirrhosis.Methods 112 patients with CHB,52 patients with hepatitis B liver cirrhosis and 33 healthy persons in our hospital between June 2015 and April 2017 were enrolled in this study.Serum IL-17,TLR4 and TGF-β1 levels were detected by enzyme linked immunosorbent assay(ELISA)and liver biopsy was performed routinely.Results Serum levels of IL-17 in patients with chronic hepatitis B,liver cirrhosis and healthy persons were(264.42±32.53)pg/ml,(271.54±33.71)pg/ml and(64.18±5.52)ng/ml,respectively,serum levels of TLR4 were(5.81±0.83)pg/ml,(37.41±6.05)pg/ml and(1.07±0.13)ng/ml respectively,and serum levels of TGF-β1 were(3.67±0.42)pg/ml,(7.82±1.07)pg/ml and(1.61±0.07)ng/ml,respectively(P<0.05);serum IL-17,TLR4 and TGF-β1 levels in 19 patients with Child-Pugh class B were(231.38±28.67)pg/ml,(18.61±2.87)pg/ml and(5.76±0.52)ng/ml,in 16 patients with class C were(301.72±32.72)pg/ml,(39.47±6.82)pg/ml and(9.42±1.27)ng/ml,both were significantly higher than in 17 patients with Child-Pugh class A【(204.53±26.57)pg/ml,(4.72±0.71)pg/ml and(3.18±0.34)ng/ml,respectively,P<0.05】;the liver biopsies showed than liver fibrosis staging So in 8,S1 in 42,S2 in 43,S3 in 19 and S4 in 52.Serum IL-17,TLR4 and TGF-β1 levels in each group of liver fibrosis were significantly different(P<0.05),and they increased as the pathological fibrosis stages got worse.Conclusion Serum levels of TLR4,TGF-β1 and IL-17 increase in patients with CHB and hepatitis B-induced liver cirrhosis,which might hint the diagnosis and the severity of liver cirrhosis.