血清白细胞介素-33对成年麻疹患者肝损伤病情进展及临床转归的影响

Effect of serum interleukin-33 on the development of disease and clinical outcomes of adult measles patients with liver damage

目的探索血清白细胞介素-33(IL-33)对成年麻疹患者肝损伤病情发生发展及临床转归的影响。方法选取本院接受治疗的256例成年麻疹患者为研究对象,其中将136例合并肝损伤患者为观察组,120例未合并肝损伤患者为对照组。另选取80例同期在本院接受体检的健康者作为健康对照组。根据是否保肝将观察组患者分为保肝组88例,未保肝组48例。检测观察组、对照组和健康对照组患者血清IL-33水平;检测并比较保肝组和未保肝组患者的谷丙转氨酶、谷氨酰转移酶以及IL-33的血清指标;对可能影响麻疹合并肝损伤患者血清IL-33的因素进行Logistic回归分析。结果观察组患者血清IL-33水平高于对照组和健康对照组(P<0.05);保肝组和未保肝组入院当天和第7天谷丙转氨酶、谷氨酰转移酶水平差异无统计学意义(P>0.05);第14天保肝组谷丙转氨酶、谷氨酰转移酶、IL-33水平显著低于未保肝组(P<0.05)。谷丙转氨酶、谷氨酰转移酶是影响麻疹合并肝损伤患者IL-33的独立危险因素。结论IL-33水平对于成年麻疹患者的肝损伤程度具有重要预示作用,对于指导临床治疗具有重要意义,是病情发生发展和临床转归的关键性预示指标。

Objective To explore the effect of serum interleukin-33(IL-33)on the development and clinical outcomes of adult measles patients with liver damage.Methods A total of 256 adult measles patients in our hospital were selected as study objects,among whom 136 patients with liver damage were selected as observation group and 120 patients without liver damage were selected as control group.Another 80 healthy subjects who conducted physical examination in our hospital at the same time were selected as the healthy control group.According to liver preservation or not,the observation group was further divided into liver preservation group(n=88)and liver un-preservation group(n=48).Serum IL-33 levels were measured in observation group,control group and healthy control group.Serum indicators such as alanine aminotransferase,glutamyltransferase,and IL-33 were detected and compared between liver preservation group and liver non-preservation group.Multivariate logistic regression analysis was performed on the factors that may affect the levels of IL-33 in liver damage patients.Results The serum IL-33 level of the observation group was significantly higher than that of the control group and the healthy control group(P<0.05);there were no significant difference in the levels of alanine aminotransferase and glutamyltransferase between liver preservation group and liver non-preservation group at admission and 7 d after admission(P>0.05).At 14 d after admission,the levels of alanine aminotransferase,glutamyltransferase and IL-33 in liver preservation group were significantly lower than those in the liver un-preservation group(P<0.05).Alanine aminotransferase,glutamyltransferase and IL-33 were independent risk factors for measles patients with liver damage.Conclusion Serum IL-33 has an important predictive effect on the degree of liver damage in adult measles patients,and it is of great significance in treatment of patients′disease,and is key predictors for the development and clinical outcomes of the disease.