诸暨地区慢性丙型肝炎患者的基因型特征分析及其与血清IL-18、IL-10表达的相关性分析

Analysis of genotypic characteristics of patients with regional chronic hepatitis C in Zhuji area and its correlation with the serum expression of IL-18 and IL-10

目的探讨诸暨地区慢性丙型肝炎患者的基因型特征分析及其与血清IL-18、IL-10表达的关系。方法选择2017年1月—2020年1月诸暨市第四人民医院和诸暨市人民医院病历资料完整的住院慢性丙型肝炎患者195例为研究对象,另选择100例体检报告各项指标均无异常的体检者为健康对照组。抽取2组空腹静脉血,检测HCV基因型、HCV-RNA载量、肝功能指标ALT、AST以及血清IL-18、IL-10表达。结果入选研究对象HCV基因分型中1b型87例(44.62%);2a型81例(41.54%);其他型27例(13.85%)。在1b型、2a型、其他型患者中,年龄、性别、感染途径及临床类型差异无统计学意义(P> 0.05),且血清肝功能指标(ALT、AST)的表达水平基本一致,差异无统计学意义(P> 0.05),但HCV-RNA载量差异有统计学意义(P<0.05)。不同HCV基因型患者血清IL-18、IL-10的表达差异有统计学意义(P<0.05),相关性分析发现IL-18、IL-10表达与患者肝功能指标ALT和AST表达呈正相关性(r值分别为0.457、0.381、0.375、0.469,P<0.05),但与病毒载量无相关性(P> 0.05)。结论诸暨地区HCV的主要流行株是1b型和2a型,且大部分是单一基因型感染;血清IL-18、IL-10表达与慢性丙型肝炎患者的病毒基因型、肝损伤和肝脏炎症活动有关,而与病毒量不存在明显相关性。

Objective To study the genotypic characteristics of chronic hepatitis C patients in Zhuji area and the relationship between the genotypic characteristics and the serum expression of IL-18 and IL-10.Methods From January 2017 to January 2020,195 inpatients with chronic hepatitis C in the Department of Gastroenterology in The Fourth People's Hospital and Zhuji People's Hospital were selected as the study subjects,and 100 healthy controls were selected as the control group.The HCV genotype,HCV-RNA load,ALT,AST and the expression of IL-18,IL-10 in serum were detected.Results Eighty-seven cases(44.62%)of type 1b,81 cases(41.54%)of type 2a and 27 cases(13.85%)of other types were selected.There was no statistical significance on the difference in age,gender,infection route and clinical type among 1b,2a and other types(P>0.05),and the expression of serum liver function indexes(ALT,AST)was basically the same,with the difference not statistically significant(P>0.05),but there was statistical significance on the difference in HCV-RNA load(P<0.05).The expression difference of IL-18 and IL-10 in sera of patients with different HCV genotypes was statistically significant(P<0.05).Correlation analysis showed that the expression of IL-18 and IL-10 was positively correlated with the expression of ALT and AST(r=0.457,r=0.381,r=0.375,r=0.469,P<0.05),but not with the viral load(P<0.05).Conclusion The main epidemic strains of HCV in Zhuji area are 1b and 2a,and most of them are single genotype infection.The expression of IL-18 and IL-10 in serum is related to the genotype,liver injury and liver inflammation in patients with chronic hepatitis C,but not to the viral quantity.