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酒精性肝硬化患者Th1/Th2型细胞因子的表达水平及临床意义
Serum Th1/Th2 cytokine levels and their clinical significance in patients with alcoholic liver cirrhosis
文章发布日期:2014年07月14日  来源:  作者:陈卫红,陈艳  点击次数:2564次  下载次数:581次

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【摘要】:目的 探讨酒精性肝硬化(ALC)患者血清Th1/Th2型细胞因子水平与肝功能的相关性以及临床意义。方法 采用流式微球阵列技术(CBA)法检测ALC患者血清Th1型细胞因子(TNFα、IFNγ、IL-12)和Th2型细胞因子(IL-10、IL-4、IL-6、IL-13)水平,分析其与ALC患者肝功能Child-Pugh分级、MELD评分及肝功能血清生化指标相关性。多组间比较Kruskal-Wallis H秩和检验,两组数据组间比较采用Mann-Whitney U检验。相关性分析采用Spearman rank检验。结果 ALC患者组Th1型细胞因子(TNFα和IFNγ) /Th2型细胞因子(IL-4、IL-10和IL-13)水平均低于健康对照组,差异有统计学意义(P<0.05),其水平随着Child-Pugh分级逐渐降低,分级之间差异无统计学意义。与病毒性肝硬化(VLC)患者组相比,除IL-4外,ALC患者Th1/Th2型细胞因子显著升高,差异有统计学意义(P<0.05)。ALC患者TNFα、IL-10和IL-13水平与PTA呈正相关(P<0.05),与TBil和MELD分值显著负相关(P<0.05),特别是IL-10、IL-13、IL-4、TNFα、IFNγ水平与患者每日酒精摄入量呈显著负相关(P<0.05)。结论 ALC患者Th1/Th2型细胞因子表达水平显著降低,与酒精摄入量和肝功能损害相关,对ALC患者临床治疗和预后判断有一定的指导作用。
【Abstract】:Objective To investigate the relationship of serum Th1/Th2 cytokine levels with liver function and their clinical significance in patients with alcoholic liver cirrhosis (ALC). Methods Thirty-four ALC patients, 13 patients with viral liver cirrhosis (VLC), and 17 healthy controls were included in the study. Serum levels of Th1 cytokines (tumor necrosis factor (TNF)-α, interferon (IFN)-γ, and interleukin (IL)-12) and Th2 cytokines (IL-10, IL-4, IL-6, and IL-13) were measured by cytometric bead array, and their correlations with Child-Pugh classification, model of end-stage liver disease (MELD) score, and biochemical parameters of liver function were analyzed. Comparison between multiple groups was made by Kruskal-Wallis H test, and comparison between two groups was made by Mann-Whitney U test. Correlation analysis was performed by Spearman rank test. Results The Th1 (TNF-α and IFN-γ)/Th2 (IL-10, IL-4, and IL-13) cytokine levels in ALC group were significantly lower than those in healthy control group (P<0.05), and these indices decreased nonsignificantly as the Child-Pugh class increased. Compared with VLC patients, ALC patients had significantly increased Th1/Th2 cytokine levels except IL-4 level (P<0.05). In ALC patients, TNF-α, IL-10, and IL-13 levels were positively correlated with prothrombin time activity (P<0.05) but negatively correlated with total bilirubin and MELD score (P<0.05); especially, the levels of IL-10, IL-13, IL-4, TNF-α, and IFN-γ were negatively correlated with daily alcohol consumption (P<0.05). Conclusion The expression of Th1/Th2 cytokines is significantly reduced in ALC patients and is correlated with alcohol intake and liver function damage. Monitoring serum Th1/Th2 cytokine levels in ALC patients is helpful for clinical treatment and prognostic evaluation.
【关键字】:肝硬化,酒精性;细胞因子类;Th1细胞;Th2细胞
【Key words】:liver cirrhosis, alcoholic; cytokines; Th1 cells; Th2 cells
【引证本文】:

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