摘要
目的了解细胞因子在急性甲型肝炎患儿中的临床意义。方法观察2014年9月-2015年1月在新疆和田地区传染病专科医院住院的甲型肝炎患儿,以年龄和性别匹配的健康儿童作为对照组,检测其血清细胞因子水平,包括IL-6、IL-8、IL-10、IL-1β、TNFα,并对肝功能、凝血功能、是否合并腹水等临床指标进行监测,比较血清细胞因子与临床特征之间的关系。正态分布的计量资料2组间比较用两独立样本t检验;非正态分布的计量资料2组间比较采用Mann-Whitney U检验。计数资料2组间比较采用χ^2检验。相关性比较采用Spearman秩相关分析。结果共纳入急性甲型肝炎患儿70例,健康对照组30例,血清检测发现急性甲型肝炎组患儿血清IL-10水平为19.60(15.50~32.08) pg/ml,明显高于正常对照组的5.00 (5.00~10.30) pg/ml(Z=-6.79,P<0.01)。急性甲型肝炎患儿血清IL-10水平与ALT(r=0.24,P=0.04)、TBil(r=0.32,P<0.01)、PT(r=0.29,P=0.01)呈正相关。此外,血清IL-10水平在黄疸型肝炎组患儿为23.20(18.04~45.00) pg/ml,而非黄疸型肝炎组患儿为18.40(14.84~24.80) pg/ml,两者之间差异具有统计学意义(Z=-2.30,P=0.02)。血清IL-10水平在合并腹水组明显高于无腹水组[42.60(19.15~73.35) pg/ml vs 19.02(15.13~27.33) pg/ml,Z=-2.42,P=0.02)。血清IL-6(Z=-0.95,P=0.34)、IL-8(Z=-0.97,P=0.33)、IL-1β(Z=-1.33,P=0.18)、TNFα(Z=-0.34,P=0.73)在急性甲型肝炎组和健康对照组间差异均无统计学意义,且在是否黄疸型肝炎、是否合并腹水组间比较,差异亦无统计学意义(P值均>0.05)。结论血清IL-10在急性甲型肝炎患儿中明显升高,且在病情偏重的黄疸型肝炎组和合并腹水组中明显升高,提示细胞因子IL-10在急性HAV感染所致的免疫损伤中发挥主要作用。
Objective To investigate the clinical significance of cytokines in children with acute hepatitis A.Methods The children with acute hepatitis A who were hospitalized in the Specialized Hospital of Infectious Diseases in Hotan,Xinjiang,from September 2014 to January 2015 were enrolled as acute hepatitis A group,and healthy children matched for age and sex were enrolled as control group.The serum levels of related inflammatory cytokines were measured,including interleukin-6( IL-6),interleukin-8( IL-8),interleukin-10( IL-10),interleukin-1β( IL-1β),and tumor necrosis factor-α( TNFα).Clinical indices such as liver function,coagulation function,and presence or absence of ascites were monitored,and the correlation between the serum cytokines and clinical features was analyzed.The two-independent-samples t test was used for comparison of normally distributed continuous data between two groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups.The chi-square test was used for comparison of categorical data between two groups.A Spearman correlation analysis was used to investigate correlation.Results A total of70 children with acute hepatitis A and 30 healthy children were enrolled.The serological test showed that the acute hepatitis A group had a significantly higher serum level of IL-10 than the control group [19.60( 15.50-32.08) pg/ml vs 5.00( 5.00-10.30) pg/ml,Z =-6.79,P<0.01].In the children with acute hepatitis A,the serum level of IL-10 was positively correlated with alanine aminotransferase( r = 0.24,P = 0.04),total bilirubin( r = 0.32,P<0.01),and prothrombin time( r = 0.29,P = 0.01).In addition,the serum level of IL-10 was 23.20( 18.04-45.00) pg/ml in children with jaundice hepatitis and 18.40( 14.84-24.80) pg/ml in those with non-jaundice hepatitis,and there was no significant difference between the two groups of children( Z =-2.30,P = 0.02).The children with ascites had a significantly higher serum level of IL-10 than those without ascites [42.60( 19.15-73.35) pg/ml vs 19.02( 15.13-27.33)pg/ml,Z =-2.42,P = 0.02].There were no significant differences between the acute hepatitis A group and the control group in the ser-um levels of IL-6( Z =-0.95,P = 0.34),IL-8( Z =-0.97,P = 0.33),IL-1β( Z =-1.33,P = 0.18),and TNFα( Z =-0.34,P = 0.73),and there were also no significant differences in these cytokines between the children with jaundice hepatitis and those with non-jaundice hepatitis,as well as between the children with ascites and those without ascites( all P>0.05).Conclusion There is a significant increase in the serum level of IL-10 in children with acute hepatitis A,especially in those with jaundice hepatitis or ascites,suggesting that IL-10 plays an important role in immunologic injury induced by acute hepatitis A virus infection.
作者
韦新焕
柳雅立
张晶
林伟
WEI Xinhuan;LIU Yali;ZHANG Jing(Department of Hepatitis C and Toxic Liver Disease, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China)
出处
《临床肝胆病杂志》
CAS
北大核心
2019年第9期1942-1945,共4页
Journal of Clinical Hepatology
基金
丰台区科技新星计划
北京市朝阳区艾滋病和病毒性肝炎等重大传染病综合示范区建设研究(2018ZX10715005-003-003,2017ZX10202202-005-010)
