CAJ | 학술논문

目的：探讨乙型性肝炎患者血清细胞因子白细胞介素-1β（IL -1β）、γ-干扰素（γ- IFN）与肝纤维化指标层黏蛋白（LN）、透明质酸（HA）、前Ⅲ胶原（PCⅢ）的水平变化及其意义。方法检测2012年5月至2014年5月收集的96例各种类型的乙型肝炎患者，其中急性肝炎组16例，慢性肝炎轻度组18例，慢性肝炎中度组21例，肝炎性肝硬化17例，慢性肝炎重度组24例。另取20例体检肝功能正常的研究对象作为对照组。观察六组对象 IL -1β、γ- IFN、LN、HA、PCⅢ水平和肝功能等指标，并比较不同类型患者间各指标的差异与相关性。结果不同组别的肝炎患者 IL -1β、γ- IFN、LN、HA、PCⅢ水平差异显著（ P <0.05）；随着肝炎病情的不断加重 IL -1β、LN、HA、PCⅢ水平不断增高，γ- IFN水平不断下降（ P <0.05）。不同肝炎严重程度疾病间的肝功能指标比较，急性肝炎患者的丙氨酸氨基转移酶（ ALT）水平显著高于其他组研究对象（ P <0.05）；随着疾病程度的加重患者的总胆红素（TBIL）逐渐升高，白蛋白（ALB）、凝血酶原活动度（PTA）逐渐降低。随着肝纤维化程度的加重，患者的 IL -1β、LN、HA、PCⅢ显著地升高，γ- IFN 显著地降低（ P <0.05）。γ- IFN 与 HA、PCⅢ呈显著的负相关，IL -1β与 HA、PCⅢ呈显著的正相关（ P <0.05），与 LN 相关性具有统计学意义（ P >0.05）。结论细胞因子 IL -1β、γ- IFN 与肝损伤有良好的相关性，且与肝纤维化的形成密切相关。LN、HA、PCⅢ水平可作为反映肝纤维化的良好指标。因此，检测乙型肝炎患者血清中 IL -1β、γ- IFN、LN、HA、PCⅢ水平对判断肝纤维化程度及评价临床治疗效果及预后具有重要意义。
목적：탐토을형성간염환자혈청세포인자백세포개소-1β（IL -1β）、γ-간우소（γ- IFN）여간섬유화지표층점단백（LN）、투명질산（HA）、전Ⅲ효원（PCⅢ）적수평변화급기의의。방법검측2012년5월지2014년5월수집적96례각충류형적을형간염환자，기중급성간염조16례，만성간염경도조18례，만성간염중도조21례，간염성간경화17례，만성간염중도조24례。령취20례체검간공능정상적연구대상작위대조조。관찰륙조대상 IL -1β、γ- IFN、LN、HA、PCⅢ수평화간공능등지표，병비교불동류형환자간각지표적차이여상관성。결과불동조별적간염환자 IL -1β、γ- IFN、LN、HA、PCⅢ수평차이현저（ P <0.05）；수착간염병정적불단가중 IL -1β、LN、HA、PCⅢ수평불단증고，γ- IFN수평불단하강（ P <0.05）。불동간염엄중정도질병간적간공능지표비교，급성간염환자적병안산안기전이매（ ALT）수평현저고우기타조연구대상（ P <0.05）；수착질병정도적가중환자적총담홍소（TBIL）축점승고，백단백（ALB）、응혈매원활동도（PTA）축점강저。수착간섬유화정도적가중，환자적 IL -1β、LN、HA、PCⅢ현저지승고，γ- IFN 현저지강저（ P <0.05）。γ- IFN 여 HA、PCⅢ정현저적부상관，IL -1β여 HA、PCⅢ정현저적정상관（ P <0.05），여 LN 상관성구유통계학의의（ P >0.05）。결론세포인자 IL -1β、γ- IFN 여간손상유량호적상관성，차여간섬유화적형성밀절상관。LN、HA、PCⅢ수평가작위반영간섬유화적량호지표。인차，검측을형간염환자혈청중 IL -1β、γ- IFN、LN、HA、PCⅢ수평대판단간섬유화정도급평개림상치료효과급예후구유중요의의。
Objective To discuss on viral hepatitis of serum cytokines in patients with interleukin - 1 beta(IL - 1 beta),interferon gamma(gamma - IFN)and liver fibrosis index of laminin(LN),hyaluronic acid(HA),the former collagen III(PC III)changes and its signifi-cance level. Methods From 2012 May to 2014 May,96 cases of various types of infection in our hospital in patients with viral hepatitis were col-lected in inspection department. 16 cases of acute hepatitis,chronic hepatitis group,18 patients with mild,moderate group of 24 cases of chronic hepatitis in 21 cases,17 cases of hepatitis,cirrhosis,chronic hepatitis and severe groups. Another 20 cases of normal liver function examination subjects were included as controls. IL - 1β,γ - IFN,LN,HA,PCⅢ levels and liver function and other indicators were observed in six groups, and compared different types of patients between the various indicators of differences and correlation. Results Differences between different groups of the IL - 1 hepatitis patients,beta,gamma - IFN,LN,HA,PC III levels were significantly( P < 0. 05). With the increase of the hepa-titisIL - 1 beta,LN,HA,PC III level rising,falling levels of gamma - IFN( P < 0. 05). Comparison of liver function indexes of different hepa-titis severity of disease,acute hepatitis ALT level is significantly higher than the other groups of subjects( P < 0. 05). With the aggravation of the disease in patients with TBIL increased,ALB and PTA decreased gradually. With the aggravation of liver fibrosis,in patients with IL - 1,LN, HA,PC beta III significantly increased,gamma - IFN significantly reduced( P < 0. 05). There was a significant positive correlation of gamma- IFN,IL - 1 beta and HA,PC III( P < 0. 05),statistically significant correlation with LN( P > 0. 05). Conclusion Cytokines IL - 1β,γ -IFN and liver damage have a good correlation,and is closely related to the formation of liver fibrosis. LN,HA,PCⅢ levels can be used as a good indicator of liver fibrosis. Therefore,detection of IL - 1β,γ - IFN,LN,HA,liver fibrosis and evaluate clinical outcomes and prognostic signifi-cance of serum levels of hepatitis B PCⅢ judgment.