慢性乙型肝炎病毒感染患者血清IL-33、sST2、MCP-1水平变化及其临床意义

Changes of serum IL-33, sST2 and MCP-1 levels in patients with chronic hepatitis B virus infection and its clinical significance

目的探讨慢性乙型肝炎病毒感染患者血清白细胞介素-33(IL-33)及其受体可溶性生长刺激表达基因2蛋白(sST2)与单核细胞趋化蛋白-1(MCP-1)表达水平变化,并分析其临床意义。方法选取2017年1月~2018年1月广东省东莞市人民医院收治的105例慢性乙型肝炎病毒感染患者作为观察组,其中单纯慢性乙肝患者67例(慢性乙肝组),合并肝衰竭38例(肝衰竭组),同期选择50名无肝脏疾病的健康志愿者作为对照组。分别测定各组血清IL-33、sST2以及MCP-1水平,并根据Ishak病理评分对慢性乙肝组患者的肝纤维化程度进行评定,比较不同肝纤维化程度患者的上述指标表达情况。结果慢性乙肝组与肝衰竭组的IL-33、sST2与MCP-1水平均明显高于对照组,且肝衰竭组的IL-33、sST2与MCP-1表达水平明显高于慢性乙肝组,差异有统计学意义(P < 0.05)。与轻度肝纤维化组比较,中度肝纤维化组、重度肝纤维化组和肝硬化组的IL-33、sST2与MCP-1均升高,且重度肝纤维化组和肝硬化组IL-33、sST2与MCP-1水平高于中度肝纤维化组,肝硬化组IL-33、sST2与MCP-1水平高于重度肝纤维化组,差异有统计学意义(P < 0.05)。经Pearson相关分析显示,慢性乙肝组患者IL-33、sST2与MCP-1与Ishak评分呈正相关(r = 0.573、0.728、0.654,P < 0.05)。结论血清IL-33、sST2与MCP-1对慢性乙型肝炎病毒感染及其病情加重有评估预测作用,对患者开展血清指标检验有助于疾病诊断与预后评估。

Objective To investigate the changes of serum levels of interleukin-33 (IL-33) and its receptor soluble growth STimulation expressed gene 2 (sST2) and monocyte chemotactic protein-1 (MCP-1) in patients with chronic hepatitis B virus infection, and to analyze their clinical significance. Methods One hundred and five patients with chronic hepatitis B virus infection in Dongguan People′s Hospital from January 2017 to January 2018 were selected as the observation group, including 67 patients with simple chronic hepatitis B (chronic hepatitis B group), 38 patients with hepatic failure (hepatic failure group), and 50 healthy volunteers without liver diseases were selected as the control group. Serum levels of IL-33, sST2 and MCP-1 were measured in each group, and the degree of hepatic fibrosis in chronic hepatitis B group was assessed according to Ishak pathological score. The expression of the above indicators in patients with different degrees of hepatic fibrosis was compared. Results The levels of IL-33, sST2 and MCP-1 in chronic hepatitis B group and hepatic failure group were significantly higher than those in control group, and the expression of IL-33, sST2 and MCP-1 in hepatic failure group was significantly higher than those in chronic hepatitis B group (P < 0.05). Compared with mild hepatic fibrosis group, the levels of IL-33, sST2 and MCP-1 in moderate hepatic fibrosis group, severe hepatic fibrosis group and cirrhosis group increased, and the levels of IL-33, sST2 and MCP-1 in severe hepatic fibrosis group and cirrhosis group were higher than those in moderate hepatic fibrosis group, while the levels of IL-33, sST2 and MCP-1 in cirrhosis group were higher than those in severe hepatic fibrosis group, the differences were statistically significant (P < 0.05). Pearson correlation analysis showed that IL-33, sST2 and MCP-1 was positively correlated with Ishak score in patients with chronic hepatitis B (r = 0.573, 0.728, 0.654, P < 0.05). Conclusion Serum IL-33, sST2 and MCP-1 can evaluate and predict chronic hepatitis B virus infection and the aggravation of the disease. The test of serological indexes for the patients is helpful for disease diagnosis and prognosis evaluation.