组合型人工肝治疗对慢加急性肝功能衰竭患者血清IL-17的影响研究

Effect of Different Modes of Artificial Liver Therapy on Serum IL-17 in Patients with Acute-on-chronic Liver Failure

目的探讨组合型人工肝治疗对慢加急性肝功能衰竭(ACLF)患者血清白细胞介素-17(IL-17)的影响。方法采用流式细胞仪检测肝损伤组、ACLF组血清IL-17的浓度含量,进一步检测ACLF患者进行血浆置换(PE)、双重血浆吸附(DPMAS)、血浆置换+双重血浆吸附(PE+DPMAS)治疗后的浓度,对比3组治疗前、治疗后指标变化。结果ACLF患者血清IL-17与肝损伤组比较有显著性差异(P<0.05)。ACLF患者进行人工肝不同模式治疗比较:PE组患者治疗前后IL-17的水平比较有统计学意义(P<0.05)。DPMAS组患者治疗前后IL-17浓度含量比较差异有统计学意义(P<0.05)。PE+DPMAS组患者治疗前后IL-17含量比较差异有统计学意义(P<0.05)。PE组、DPMAS组、PE+DPMAS组患者治疗前IL-17浓度差异无统计学意义(P>0.05);3组治疗后比较:PE+DPMAS组与PE组、DPMAS组间IL-17浓度差异有统计学意义(P<0.05)。PE组与DPMAS组比较IL-17浓度差异有统计学意义(P<0.05)。结论①ACLF患者IL-17浓度高于肝损伤组。②PE组、DPMAS组、PE+DPMAS组患者治疗ACLF均可以有效清除IL-17。其中PE+DPMAS治疗模式对ACLF患者血清IL-17的清除效果明显优于PE和DPMAS治疗组,DPMAS组清除IL-17的能力优于PE组。

Objective To investigate the effects of different modes of artificial liver therapy on serum interleukin-17(IL-17)in patients with acute-on-chronic liver failure(ACLF).Methods Flow cytometry was used to detect the serum IL-17 concentration in the liver injury group and ACLF group,and to further detect plasma exchange(PE),dual plasma adsorption(DPMAS),plasma exchange+dual plasma adsorption(PE+DPMAS)treatments in ACLF patients after the concentration,compare the index changes of the three groups before and after treatment.Results There was a significant difference between serum IL-17 and liver injury in patients with ACLF(P<0.05).The comparison of different modes of artificial liver therapy in patients with ACLF:the differences of serum IL-17 between the pre-and post-treatment of PE group was statistically significant(P<0.05).The differences of serum IL-17 before and after treatment of DPMAS group was statistically significant(P<0.05).The differences of serum IL-17 before and after treatment of PE+DPMAS group was statistically significant(P<0.05).There were no significant differences of serum IL-17 between PE group,DPMAS group and PE+DPMAS group before treatment(P>0.05).After the three groups of treatment,the differences of serum IL-17 between the PE+DPMAS group and the PE group and the DPMAS group was significant and statistically significant(P<0.05).The differences of serum IL-17 between PE group and DPMAS group was statistically significant(P<0.05).Conclusion The concentration of cytokine IL-17 in ACLF patients is higher than that in liver injury group.The treatment of acute-on-chronic liver failure in PE group,DPMAS group and PE+DPMAS group could effectively remove the cytokine IL-17.The removal effect of PE+DPMAS treatment model on serum IL-17 in ACLF patients is significantly better than that of PE and DPMAS treatment group.The ability of the DPMAS group to clear IL-17 is better than that of the PE group.