慢性乙型肝炎患者血清白介素17A和胆碱酯酶的表达及临床意义

Expression and Clinical Significance of Serum IL-17A and CHE in Patients with Chronic Hepatitis B

目的:检测慢性乙型肝炎(CHB)患者血清白介素17A(IL-17A)、胆碱酯酶(CHE)水平,并分析其临床意义。方法:选取2018年1月到2019年3月期间在重庆三峡中心医院接受治疗的CHB患者84例,根据病情严重程度将所有患者分为轻度组30例、中度组28例、重度组26例,另选取同期在重庆三峡中心医院进行体检的健康志愿者50例作为对照组。比较各组的凝血四项指标[纤维蛋白原(FIB)、凝血酶原时间(PT)、凝血活酶时间(APTT)、凝血酶时间(TT)]、肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)]、IL-17A、CHE水平,采用Pearson相关分析CHB患者血清IL-17A、CHE与凝血四项、ALT、AST的相关性。结果:重度组、中度组、轻度组、对照组的FIB、CHE水平逐渐升高,PT、APTT、TT、ALT、AST、IL-17A水平逐渐降低,两两比较均有统计学差异(P<0.05),IL-17A与FIB、CHE呈负相关,与PT、APTT、TT、ALT、AST呈正相关(P<0.05);CHE与FIB呈正相关,与PT、APTT、TT、ALT、AST呈负相关(P<0.05)。结论:CHB患者血清中IL-17A、CHE水平与患者的肝功能和凝血功能密切相关,联合检测IL-17A和CHE有助于患者的病情评估以及预后判断。

Objective: Detection of serum interleukin 17A(IL-17A) and cholinesterase(CHE) levels in patients with chronic hepatitis B(CHB), and to analyze its clinical significance. Methods: 84 cases of CHB who were treated in Chongqing Three Gorges Central Hospital from January 2018 to March 2019 were selected, they were divided into 30 cases of mild group, 28 cases in moderate group and 26 cases in severe group according to the severity of the disease, another 50 healthy volunteers in Chongqing Three Gorges Central Hospital during the same period were selected as control group. Four indexes of coagulation [fibrinogen(FIB), prothrombin time(PT), thromboplastin time(APTT), thrombin time(TT), liver function index [alanine transaminase(ALT), cereal transaminase(AST)],IL-17A, CHE level were compared in each group, pearson correlation analysis was used to analyze the correlation between serum IL-17A, CHE and four indexes of coagulation, ALT and AST in CHB patients. Results: The levels of FIB and CHE in severe group,moderate group, mild group and control group increased gradually, the level of PT, APTT, TT, ALT, AST and IL-17A decreased gradually, and there were statistically significant differences(P<0.05). IL-17A was negatively correlated with FIB and CHE, positively correlated with PT, APTT, TT, ALT and AST(P <0.05). There was a positive correlation between CHE and FIB, and negatively correlated with PT, APTT, TT, ALT, AST(P<0.05). Conclusion: The expression of IL-17A and CHE in the serum of CHB patients is closely related to the patient’s liver function and blood coagulation function, combined detection of IL-17A and CHE can help patients to assess their condition and prognosis.