慢加急性乙型肝炎肝衰竭患者血清IL-10和GP73水平检测及其临床意义

Implication of serum IL- 10 and GP73 levels in patients with HBV- related acute- on- chronic liver failure

目的探讨HBV相关慢加急性肝衰竭(HBV-ACLF)患者血清IL-10和GP73水平变化及其临床意义。方法在56例HBV-ACLF患者、32例慢性乙型肝炎(CHB)患者和20例健康人,采用酶联免疫吸附法检测基线血清IL-10和GP73水平。随访HBV-ACLF患者3个月,进行重复检测。结果基线时HBV-ACLF组血清IL-10水平为(32.4±14.8) pg/ml,显著高于CHB组的(15.2±6.3) pg/ml或健康人的(6.1±1.9) pg/ml (P<0.05);HBV-ACLF组血清GP73水平为(283.4±95.4) ng/ml,显著高于CHB组的(129.7±58.1) ng/ml或健康人的(45.5±16.2) ng/ml(P<0.05);33例生存的HBV-ACLF患者基线血清IL-10水平为(34.6±15.3) pg/ml,显著高于23例死亡患者的(30.1±14.3) pg/ml (P<0.05),但生存组与死亡组血清GP73水平差异无统计学意义【(279.7±94.6) ng/ml对(287.2±96.2) ng/ml,P=0.36】;治疗2周时,HBV-ACLF生存组血清IL-10水平为(30.1±14.0)pg/ml,仍显著高于死亡组的(24.9±11.2) pg/ml(P<0.05),但不同于基线时,治疗2周时生存与死亡患者血清GP73水平出现了统计学差异【(258.7±85.9) ng/ml对(331.2±107.5) ng/ml,P<0.05】。结论 HBV-ACLF患者血清IL-10水平高者可能预后相对较好,而动态观察血清GP73水平变化可能对预测HBV-ACLF患者的短期预后也有一定的价值。

Objective To investigate the implication of serum IL-10 and GP73 levels in patients with HBV-related acute-on-chronic liver failure(HBV-ACLF). Methods Serum IL-10 and GP73 levels were measured by ELISA in fifty-six patients with HBV-ACLF,thirty-two patients with chronic hepatitis B(CHB),and twenty healthy persons. All patients with HBV-ACLF were followed-up for 3 months. Results At presentation,serum IL-10 level in patients with HBV-ACLF were(32.4±14.8) pg/ml,significantly higher than(15.2±6.3) pg/ml in patients with CHB or(6.1±1.9) pg/ml in healthy control(P<0.05),and serum GP73 level in patients with HBV-ACLF were(283.4±95.4) ng/ml,also significantly higher than(129.7±58.1) ng/ml in patients with CHB or(45.5±16.2) ng/ml in the control(P<0.05);at baseline,serum IL-10 levels in 33 survivals with HBV-ACLF were(34.6 ±15.3) pg/ml,significantly higher than(30.1 ±14.3) pg/ml in 23 dead ones(P <0.05),and there was no significant difference between the survival and the dead as respect to their serum GP73 levels [(279.7±94.5) ng/ml vs.(287.2±96.2) ng/ml,P=0.36];two weeks after treatment,serum IL-10 levels in survival group with HBVACLF were(30.1±14.0) pg/ml,still significantly higher than(24.9±11.2) pg/ml in dead group(P<0.05),and there was a significant difference of serum GP73 levels in the survival and dead [(258.7 ±85.9) ng/ml vs.(331.2 ±107.5) ng/ml,P <0.05]. Conclusion The HBV-ACLF patients with high serum IL-10 level might have a relatively good prognosis,and the dynamic detection of serum GP73 level might be of certainly significance in assessing short-term prognosis of patients with HBV-ACLF.