血清IL-33和sST2表达水平与慢性乙型肝炎患者病情相关性研究
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摘要
目的探讨血清可溶性生长刺激表达基因2蛋白(sST2)、白细胞介素-33(IL-33)、丙氨酸转移酶(ALT)和天门冬氨酸氨基转移酶(AST)与慢性乙型肝炎病毒(HBV)感染患者病情严重程度的相关性,为慢性HBV感染的临床防治提供参考。方法选取医院2017年1月-2018年6月住院治疗的100例慢性HBV感染患者作为感染组,同期医院内行健康体检正常者30例作为对照组,所有研究对象检测血清sST2、IL-33、ALT、AST指标水平,对慢性HBV感染患者行肝穿刺病理检测,进行纤维化程度评估分期。结果感染组患者血清sST2、IL-33、ALT、AST指标水平均高于对照组(P<0.05);100例慢性HBV感染患者肝纤维化分期结果:11例F0期、27例F1期、26例F2期、22例F3期、14例F4期。其中肝纤维化75例、肝硬化14例,分别占75.00%、14.00%;不同病情严重程度患者血清sST2、IL-33、ALT、AST水平比较差异有统计学意义(P<0.05),肝硬化患者指标水平最高;Pearson相关性分析显示,sST2、IL-33、ALT、AST之间呈正相关(P<0.05)。结论血清sST2、IL-33、ALT、AST水平与慢性HBV感染患者的病情严重程度密切相关,可反映肝纤维化进程。
OBJECTIVE To explore the correlation between the serum soluble growth stimulating expression gene 2 protein(sST2),interleukin-33(IL-33),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and severity of the patients with chronic hepatitis B virus(HBV)infection so as to provide guidance for clinical prevention and control of the chronic HBV infection.METHODS Totally 100 patients with chronic HBV infection who were hospitalized from Jan 2017 to Jun 2018 were chosen as the infection group,meanwhile,30 healthy people who received physical examination were set as the control group.The levels of serum sST2,IL-33,ALT and AST of all the study objects were detected,the liver puncture was performed for pathological examination of the patients with chronic HBV infection,and the fibrosis degree was assessed.RESULTS The levels of serum sST2,IL-33,ALT and AST of the infection group were significantly higher than those of the control group(P<0.05).The result of the hepatic fibrosis staging of the 100 patients with chronic HBV infection showed that there were 11 cases of stage F0,27 cases of F1,26 cases of F2 and 14 cases of F4;there were 75(75.00%)cases of hepatic fibrosis and 14(14.00%)cases of liver cirrhosis.There were significant differences in the levels of serum sST2,IL-33,ALT and AST among the patients with various severity of disease(P<0.05).The levels of the indexes of the patients with liver cirrhosis were highest.Pearson correlation analysis indicated that the sST2,IL-33,ALT and AST were positively correlated(P<0.05).CONCLUSIONThe levels of serum sST2,IL-33,ALT and AST are closely associated with the severity of the patients with chronic HBV infection,which may reflect the progress of liver fibrosis.
OBJECTIVE To explore the correlation between the serum soluble growth stimulating expression gene 2 protein(sST2),interleukin-33(IL-33),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and severity of the patients with chronic hepatitis B virus(HBV)infection so as to provide guidance for clinical prevention and control of the chronic HBV infection.METHODS Totally 100 patients with chronic HBV infection who were hospitalized from Jan 2017 to Jun 2018 were chosen as the infection group,meanwhile,30 healthy people who received physical examination were set as the control group.The levels of serum sST2,IL-33,ALT and AST of all the study objects were detected,the liver puncture was performed for pathological examination of the patients with chronic HBV infection,and the fibrosis degree was assessed.RESULTS The levels of serum sST2,IL-33,ALT and AST of the infection group were significantly higher than those of the control group(P<0.05).The result of the hepatic fibrosis staging of the 100 patients with chronic HBV infection showed that there were 11 cases of stage F0,27 cases of F1,26 cases of F2 and 14 cases of F4;there were 75(75.00%)cases of hepatic fibrosis and 14(14.00%)cases of liver cirrhosis.There were significant differences in the levels of serum sST2,IL-33,ALT and AST among the patients with various severity of disease(P<0.05).The levels of the indexes of the patients with liver cirrhosis were highest.Pearson correlation analysis indicated that the sST2,IL-33,ALT and AST were positively correlated(P<0.05).CONCLUSIONThe levels of serum sST2,IL-33,ALT and AST are closely associated with the severity of the patients with chronic HBV infection,which may reflect the progress of liver fibrosis.
引文
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[22]高银杰,赵景民.肝脏疾病中白细胞介素33免疫调节作用的研究进展[J].肝脏,2014,19(7):540-543.
[23]Rinella ME.Nonalcoholic fatty liver disease:a systematic review[J].JAMA,2015,313(22):2263-2273.
[24]郑绍同,王书中,杨士军,等.慢性乙型病毒性肝炎患者血清IL-33和sST2表达水平及临床诊治意义[J].中国中西医结合消化杂志,2017,25(9):666-670.
[2]中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2015年更新版)[J].临床肝脏病杂志,2015,31(12):1941-1958.
[3]Wang FS,Fan JG,Zhang Z,et al.The global burden of liver disease:the major impact of China[J].Hepatology,2014,60(6):2099-2108.
[4]倪倩,胡世莲,尹辉.IL-33与人类疾病关系的研究进展[J].国际免疫学杂志,2013,36(5):355-358.
[5]陈国梁,项美姣,张家敏,等.四种常见血清肝酶在乙型肝炎相关性肝癌中的表达及意义[J].中华医院感染学杂志,2017,27(3):525-527.
[6]Gaggini MC,Navarro RS,Stefanini AR,et al.Correlation between METAVIR scores and Raman spectroscopy in liver lesions induced by hepatitis C virus:apreliminary study[J].Lasers Med Sci,2015,30(4):1347-1355.
[7]Forbi JC,Dillon M,Purdy MA,et al.Molecular epidemiology of hepatitis B virus infection in Tanzania[J].J Gen Virol,2017.
[8]Nannini P,Sokal EM.Hepatitis B:changing epidemiology and interventions[J].Arch Dis Child,2017,102(7):676-680.
[9]Chang MS,Nguyen MH.Epidemiology of hepatitis B and the role of vaccination[J].Best Pract Res Clin Gastroenterol,2017,31(3):239-247.
[10]Tada T,Kumada T,Toyoda H,et al.Hepatitis B virus corerelated antigen levels predict progression to liver cirrhosis in hepatitis B carriers[J].J Gastroenterol Hepatol,2018,33(4):918-925.
[11]Warren-Gash C,Childs K,Thornton A,et al.Cirrhosis and liver transplantation in patients co-infected with HIV and hepatitis B or C:an observational cohort study[J].Infection,2017,45(2):215-220.
[12]胡烨,张国.肝纤维化诊断及其严重程度评估[J].实用肝脏病杂志,2017,20(1):13-16.
[13]陈柳莹,陆伦根.重视慢性肝病的病情评估[J].实用肝脏病杂志,2017,20(1):4-6.
[14]Harman DJ,Ryder SD,James MW,et al.Obesity and type 2 diabetes are important risk factors underlying previously undiagnosedcirrhosis in general practice:a cross-sectional study using transient elastography[J].Aliment Pharmacol Ther,2018,47(4):504-515.
[15]Park CC,Nguyen P,Hernandez C,et al.Magnetic resonance elastography vs transient elastography in detection of fibrosis and noninvasive measurement of steatosis in patients with biopsy-proven nonalcoholic fatty liver disease[J].Gastroenterology,2017,152(3):598-607.e2.
[16]王志杰,宋波,刘新静,等.IL-33基因多态性与疾病易感性的研究进展[J].河南医学研究,2017,26(10):1776-1778.
[17]Gao Q,Li Y,Li M.The potential role of IL-33/ST2signaling in fibrotic diseases[J].J Leukoc Biol,2015,98(1):15-22.
[18]Xu J,Miao X,Zheng J,et al.Therapeutic effects of Saikosapoin D on bleomycininduced pulmonary fibrosis in mice via regulation of IL-33/ST2pathway[J].TJPR,2017,16(3):581-588.
[19]李欣,朱英.肝纤维化发生相关信号传导通路研究进展[J].实用肝脏病杂志,2015,18(1):101-104.
[20]McLaughlin T,Ackerman SE,Shen L,et al.Role of innate and adaptive immunity in obesity-associated metabolic disease[J].J Clin Invest,2017,127(1):5-13.
[21]许嘉彬,安海燕.白细胞介素-33的生物学功能与肝纤维化[J].中华肝脏病杂志,2014,22(12):959-960.
[22]高银杰,赵景民.肝脏疾病中白细胞介素33免疫调节作用的研究进展[J].肝脏,2014,19(7):540-543.
[23]Rinella ME.Nonalcoholic fatty liver disease:a systematic review[J].JAMA,2015,313(22):2263-2273.
[24]郑绍同,王书中,杨士军,等.慢性乙型病毒性肝炎患者血清IL-33和sST2表达水平及临床诊治意义[J].中国中西医结合消化杂志,2017,25(9):666-670.