Ⅰ型自身免疫性肝炎患者血清25-羟基维生素D水平与炎性细胞因子表达的相关性

Correlation between serum 25-hydroxy vitamin D level and inflammatory cytokines expression in patients with type Ⅰ autoimmune hepatitis

目的分析Ⅰ型自身免疫性肝炎(AIH)患者血清25-羟基维生素D[25(OH)D]水平与炎性细胞因子表达的相关性。方法选取2013年1月至2020年6月在我院接受治疗的87例Ⅰ型AIH患者作为研究对象,另选取同期87例健康体检者作为对照组。比较急性、慢性Ⅰ型AIH患者和对照组的血清25(OH)D水平;比较不同血清25(OH)D水平患者的各项血清炎性细胞因子水平。分析影响坏死性炎症活动的相关因素。结果急性、慢性Ⅰ型AIH患者的血清25(OH)D水平均低于对照组(P<0.05),且急性Ⅰ型AIH患者的血清25(OH)D水平低于慢性Ⅰ型AIH患者(P<0.05)。血清25 (OH)D水平<15 ng/mL患者的IL-1β、IL-33和IFN-γ水平高于血清25 (OH)D水平≥15 ng/mL的患者(P<0.05)。单因素分析结果显示,ALB、PT、IgG和血清25(OH)D是影响坏死性炎症活动的相关因素(P<0.05)。多因素Logistic回归分析结果显示,血清25(OH)D<15 ng/mL是影响坏死性炎症活动的独立危险因素(P<0.05)。结论血清25(OH)D对于Ⅰ型AIH患者的免疫调节至关重要,25(OH)D可能通过影响炎性细胞因子的产生对Ⅰ型AIH的严重程度产生重要影响。

Objective To analyze the correlation between serum 25-hydroxy vitamin D[25(OH)D] level and inflammatory cytokine expression in patients with type Ⅰ autoimmune hepatitis(AIH).Methods A total of 87 patients with type ⅠAIH treated in our hospital from January 2013 to June 2020 were selected as the research objects,and 87 healthy subjects who underwent physical examination at the same period were selected as control group.The serum 25(OH)D level of acute and chronic type Ⅰ AIH patients and the control group were compared;the serum inflammatory cytokines levels of patients with different serum 25(OH)D levels were compared.The related factors affecting necroinflammatory activity were analyzed.Results The serum 25(OH)D level of acute and chronic type Ⅰ AIH patients was lower than that of the control group( P<0.05),and the serum 25(OH)D level of acute type Ⅰ AIH patients was lower than that of chronic type Ⅰ AIH patients(P<0.05).The levels of IL-1β,IL-33 and IFN-γ in patients with serum 25(OH)D level<15 ng/mL were higher than those in patients with serum 25(OH)D level ≥15 ng/mL(P <0.05).Univariate analysis results showed that ALB,PT,IgG and serum 25(OH)D were related factors affecting necroinflammatory activity(P<0.05).Multivariate Logistic regression analysis results showed that serum 25(OH)D < 15 ng/mL was an independent risk factor for necroinflammatory activity(P <0.05).Conclusion Serum 25(OH)D is critical for immune regulation in patients with type Ⅰ AIH,and 25(OH)D may have an important impact on the severity of type Ⅰ AIH disease by affecting the production of inflammatory cytokines.