丙型肝炎患者血清IL-17与ALT、AST、TBil的相关性分析

发布时间：2018-11-09 13:50

【摘要】：目的：通过检测丙型肝炎肝硬化患者、慢性丙型肝炎患者和正常对照组血清中ALT、AST、TBil以及细胞因子IL-17浓度水平变化,及不同患病组IL-17与ALT、AST、 TBil的相关性研究,探讨在丙型肝炎疾病发展的不同阶段的变化特点。按照病毒载量分组的研究,探讨病毒载量与IL-17、ALT、AST、TBil之间的相关性。同时比较抗病毒治疗前后患者细胞因子IL-17的变化,探讨IL-17在丙型肝炎的发病机制方面的作用的研究。方法：85例丙型肝炎患者其中包括24例丙型肝炎肝硬化患者和61例慢性丙型肝炎患者,选择其中20例病毒载量1×103的丙型肝炎患者进行聚乙醇干扰素联合利巴韦林治疗疗效观察,同期30例健康人作为对照。所有丙型肝炎患者抗-HCV抗体检测S/C03.8(排除抗-HCV假阳性患者),将研究对象分为4组进行研究。采用全自动生化分析仪检测所有研究对象的ALT、AST、TBil的水平,采用酶联免疫吸附实验-双抗体夹心法(ELISA)检测所有研究对象血清中抗-HCV抗体和细胞因子IL-17水平。采用荧光定量聚合酶链反应(RT-PCR)检测HCV-RNA的病毒载量。结果：(1)通过多组两两比较结果,IL-17、ALT、AST、TBil水平Ⅱ组、Ⅲ组与Ⅳ组(健康对照组)相比P(0.05,Ⅲ组与Ⅰ组相比P0.05,差异具有统计学意义。IL-17、ALT、AST水平II组与I组相比P0.05,IL-17水平I组与IV组(健康对照组)相比P0.05,差异具有统计学意义。各组IL-17水平与ALT、AST、TBil水平做相关性分析,结果显示Ⅱ组(抗-HCV(+),HCV-RNA1×103)IL-17水平与ALT、AST、TBil水平之间呈正相关(r=0.579,r=0.516,r=0.203)。(2)按照病毒载量HCV-RNA高低分组,病毒载量与IL-17水平呈正相关,随着病毒载量的升高IL-17水平也随之升高。(3)治疗前后IL-17、ALT、AST水平比较P0.05,差异有统计学意义。经抗病毒治疗后ALT、AST浓度的均值水平下降,IL-17水平上升。结论：患者组IL-17、ALT、AST、TBil的检测水平较健康对照组有所增高,可能与患者肝细胞的炎性损伤有关,同时II组IL-17水平与ALT、AST、TBil的水平变化呈正相关,说明IL-17在一定程度上能够反映肝脏的损伤程度。经抗病毒治疗后患者ALT、AST水平下降,说明肝细胞的炎性反应程度有所缓解,IL-17水平升高,说明IL-17不仅参与了炎性反应的发生过程,而且在炎症缓解的过程中也发挥着重要的作用,为临床提供了新的治疗依据。
[Abstract]:Objective: to study the changes of serum ALT,AST,TBil and cytokine IL-17 levels in patients with hepatitis C cirrhosis, chronic hepatitis C patients and normal controls, and the correlation between IL-17 and ALT,AST, TBil in different groups. To explore the characteristics of hepatitis C disease at different stages of development. The correlation between viral load and IL-17,ALT,AST,TBil was discussed according to the study of viral load grouping. The changes of cytokine IL-17 before and after antiviral therapy were compared to explore the role of IL-17 in the pathogenesis of hepatitis C. Methods: 85 patients with hepatitis C, including 24 patients with cirrhosis of hepatitis C and 61 patients with chronic hepatitis C. 20 patients with hepatitis C with viral load of 1 脳 103 were treated with interferon polyethanol combined with ribavirin. In the same period, 30 healthy persons were used as control. All patients with hepatitis C were tested for anti-HCV antibody (excluding anti-HCV false positive patients) and the subjects were divided into 4 groups. The levels of ALT,AST,TBil in all subjects were detected by automatic biochemical analyzer, and the levels of anti HCV antibody and cytokine IL-17 in serum of all subjects were detected by enzyme linked immunosorbent assay (Elisa) and double antibody sandwich method (ELISA). The viral load of HCV-RNA was detected by fluorescence quantitative polymerase chain reaction (RT-PCR). Results: (1) the IL-17,ALT,AST,TBil level of group 鈪，

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