Serum Th1 /Th2 cytokine levels and their clinical significance in patients with alcoholic liver cirrhosis
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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。方法收集解放军302医院2011年4月至2012年12月收治的34例ALC住院患者,同时选取同期病毒性肝硬化(VLC)患者13例和健康人17例作为对照。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。多组间比较采用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...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 17healthy 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 ( TNFα and IFNγ) /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, TNFα, 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, TNFα, and IFNγ 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.
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Key words:
- liver cirrhosis, alcoholic /
- cytokines /
- Th1 cells /
- Th2 cells
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