乙型肝炎后肝硬化代偿期患者血清炎性因子和肝功能变化与预后关系

Relationship between serum inflammatory factors and liver function changes and prognosis in patients with compensated liver cirrhosis after hepatitis B

目的探讨乙型肝炎后肝硬化代偿期患者的血清炎性因子和肝功能变化,以及与预后的关系。方法选取湖北工业大学医院2014年01月至2017年01月的120例乙型肝炎后肝硬化代偿期患者进行研究,随访2年,根据预后情况分为预后好组(n=88)和预后差组(n=32),2组患者治疗前、治疗后1个月、6个月、12个月、24个月血清炎性因子和肝功能水平,分析血清炎性因子和肝功能变化与预后的关系。结果治疗后1个月、6个月、12个月、24个月预后好组患者的IL-6、IL-8及TNF-α水平明显低于预后差组,差异具有统计学意义( P =0.003,0.001,0.012;P =0.001,0.009,0.012;P =0.002,0.002,0.000;P = 0.001,0.001,0.000);治疗后1个月、6个月、12个月、24个月预后好组患者的HBV-DNA、ALT、AST、TB、HA、PCⅢ、LN水平明显低于预后差组,差异具有统计学意义( P =0.032,0.008,0.015,0.033,0.025,0.012,0.025;P =0.017,0.005,0.021,0.009,0.005,0.004,0.011;P =0.008,0.001,0.015,0.003,0.001,0.000,0.000;P =0.007,0.000,0.000,0.003,0.000,0.000,0.001)。结论乙型肝炎后肝硬化代偿期患者进行抗病毒治疗后的血清炎性因子和肝功能变化与预后有关。

Objective To investigate the changes of serum inflammatory factors, liver function and prognosis in patients with compensated liver cirrhosis after hepatitis B. Methods From January 2014 to January 2017, 120 compensated patients with post-hepatitis B cirrhosis were enrolled in the study. The patients were followed up for two years. According to prognosis, the patients were divided into two groups: good prognosis group (n=88) and poor prognosis group (n=32). Before treatment, 1 month, 6 months, 12 months and 24 months after treatment, the levels of serum inflammatory factors and liver function in the two groups were evaluated, and the relationship between the changes of serum inflammatory factors and liver function and prognosis was analyzed. Results The levels of inflammatory factors IL-6,IL-8 and TNF-α in the patients with good prognosis at 1 month, 6 months, 12 months and 24 months after treatment were significantly lower than those with poor prognosis( P =0.003, 0.001, 0.012;P =0.001, 0.009, 0.012;P =0.002, 0.002, 0.000;P =0.001, 0.001,0.000);The levels of HBV-DNA, ALT, AST, TB, HA, PC III and LN in the patients with good prognosis at 1 month, 6 months, 12 months and 24 months after treatment were significantly lower than those with poor prognosis ( P =0.032, 0.008, 0.015, 0.033, 0.025, 0.012, 0.025;P =0.017, 0.005, 0.021, 0.009, 0.005, 0.004, 0.011;P =0.008, 0.001, 0.015, 0.003, 0.001, 0.000, 0.000;P =0.007, 0.000, 0.000, 0.003, 0.000, 0.000, 0.001). Conclusion The changes of serum inflammatory factors and liver function in patients with compensated post-hepatitis B cirrhosis after antiviral therapy were correlated with the prognosis.