血浆置换对慢性乙型重型肝炎患者血清细胞因子影响的研究(1)
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[摘要] 目的：研究血浆置换对慢性乙型重型肝炎患者血清白介素-12(IL-12)、白介素-18(IL-18)和白介素-10(IL-10)的影响。方法：40例慢性乙型重型肝炎患者，分别在血浆置换治疗前后检测血清IL-12、IL-18和IL-10的水平，同时检测肝功能、凝血酶原活动度(PTA)，并与健康对照组比较。结果：慢性乙型重型肝炎患者治疗前血清IL-12、IL-18水平明显升高，IL-10水平下降(均P<0.01)；血浆置换治疗后血清IL-12、IL-18水平较前显著下降，IL-10水平较前显著升高(均P<0.01)。血浆置换治疗对肝功能的恢复及 PTA的升高有明显疗效。结论：血浆置换可降低慢性乙型重型肝炎患者血清IL-12、IL-18的水平，提升IL-10的水平，保护肝细胞，促进病情的恢复。
[关键词] 血浆置换；慢性乙型重型肝炎；白细胞介素
[中图分类号] R575.1[文献标识码]A [文章编号]1673-7210(2010)11(b)-033-02
Study of plasma exchange on serum cytokines in patients with chronic severe hepatitis B
DING Ningling, ZHU Xiang, WANG Yongping
(Department of Infectious Disease, the Fifth People′s Hospital of Suzhou City, Jiangsu Province, Suzhou 215007, China)
[Abstract] Objective: To study the change of serum IL-12、IL-18 and IL-10 in patients with chronic severe hepatitis (CSH) B treated by plasma exchange(PE). Methods: 40 patients were tested the level of IL-12, IL-18, IL-10 and liver function and PTA before and after PE, and compared with those of healthy control group. Results: Before PE, the level of IL-12, IL-18 in patients with CSH B went up obviously, while the level of IL-10 went down obviously (all P<0.01) compared with the healthy people. After PE, the level of IL-12, IL-18 went down, while the level of IL-10 went up (all P<0.01). PE treatment had obvious effect in the recovery of liver function and the increase of PTA. Conclusion: PE can reduce the level of IL-12, IL-18 and ascend the level of IL-10 in the patients with CSH B. It can protect the liver cells and help recovery for patients.
[Key words] Plasma exchange; Chronic severe hepatitis B; Interleukin
血浆置换是目前临床上广泛应用于重型肝炎的有效辅助治疗手段，我院在综合药物治疗的基础上加用血浆置换治疗慢性乙型重型肝炎，取得了较好疗效。为进一步研究其治疗重型肝炎的机制，笔者检测了40例慢性乙型重型肝炎患者治疗前后血清白介素-12(IL-12)、白介素-18(IL-18)及白介素-10(IL-10)的水平，现报道如下：
1 资料与方法
1.1 一般资料
选择40例我院2008年1月～2010年1月住院的慢性乙型重型肝炎患者，其中，男30例，女10例；年龄22～65岁，平均36.5岁。诊断符合2000年西安全国病毒性肝炎会议制订的诊断分型标准。选取15例我院健康体检成人为对照组。
1.2 治疗方法
患者入院后均按重型肝炎进行常规治疗，如应用促肝细胞生长素、甘草酸二铵、前列腺素E1等静脉滴注，在护肝降酶的基础上适当用新鲜血浆、白蛋白支持，并对并发症进行相应处理。治疗组加用血浆置换治疗 ......
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