炎症相关细胞因子在慢乙肝疾病进程中的表达水平及临床指标相关性
Expression Level of Inflammation-Related Cytokines in the Progression of Chronic Hepatitis B and Their Correlation with Clinical Indexes

目的：分析慢性乙型肝炎(CHB)、肝硬化(LC)及肝细胞癌(HCC)患者免疫细胞所分泌细胞因子的表达水平及临床指标相关性，为临床的诊断治疗提供参考依据。方法：选取2020年3月1日至5月31日期间昆明市第三人民医院确诊CHB患者106例，LC患者96例，HCC患者21例，全自动生化分析仪检测肝功能指标，谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、间接胆红素(IBIL)、直接胆红素(DBIL)的变化，多重微球流式免疫荧光发光法检测细胞因子IL-1β、IL-2、IL-4、IL-5、IL-6、IL-8、IL-10、IL-12P70、IL-17、TNF-α、IFN-γ、IFN-α的表达变化，并对上述肝功能指标及细胞因子的相关性进行分析。100例健康体检人群作为正常对照组进行比较。结果CHB、LC、HCC组AST、ALT、TBIL、DBIL、IBIL表达均高于正常对照组。除IL-5、IFN-α及IL-6以外，CHB、LC、HCC组中IL-2、IL-1β、IFN-γ、IL-8、IL-17、IL12P70、TNF-α表达较正常对照组显著增加(P < 0.05)，IL-4、IL-10表达较正常对照组显著降低(P < 0.05)，其中TNF-α、IL-4在CHB、LC、HCC组患者中比较差异具有统计学意义(P < 0.05)。细胞因子IL-17、TNF-α与AST、ALT、TBIL、DBIL、IBIL显著相关(P < 0.05)。结论：CHB、LC、HCC患者中促炎细胞因子(IL-1β、IL-2、IL-5、IL-6、IL-8、IL12P70、IL-17、TNF-α、IFN-γ、IFN-α)分泌增多，抗炎细胞因子IL-4、IL-10分泌减少，提示肝脏疾病时，炎症免疫反应增加，进一步导致肝脏细胞损伤，增加疾病进展风险。
Objective: To detect the expression levels of cytokines secreted by immune cells in patients with chronic hepatitis B (CHB), liver cirrhosis (LC) and hepatocellular carcinoma (HCC), and to investigate their correlation with clinical indicators, and in order to provide new for clinical diagnosis and treatment. Methods: 106 cases of CHB, 96 cases of LC, 21 cases of HCC from March 1, 2020 to May 31, 2020, in the third people’s Hospital of Kunming. The changes of liver function indexes such as ALT, AST, TBIL, IBIL and DBIL were detected by automatic biochemical analyzer. The expression of cytokines IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12P70, IL-17, TNF-α, IFN-γ and IFN-α in peripheral blood was detected by multiple microsphere flow immunofluorescence assay. And the correlation between the above liver function indexes and cytokines was analyzed. As comparison, 100 healthy people served as normal control group. Results: The expressions of AST, ALT, TBIL, DBIL and IBIL in CHB, LC and HCC groups were higher than normal control group. Excepted IL-5, IFN-α and IL-6, the expression of IL-2, IL-1 β, IFN-γ, IL-8, IL-17, IL-12P70 and TNF-α in CHB, LC and HCC group was significantly higher than normal control group (P < 0.05), while the expression of IL-4 and IL-10 was significantly lower than normal control group (P < 0.05). There were significant differences in TNF-α and IL-4 among CHB, LC and HCC groups (P < 0.05). Cytokines IL-17 and TNF-α were significantly correlated with AST, ALT, TBIL, DBIL and IBIL (P < 0.05). Conclusion: The secretion of pro-inflammatory cytokines (IL-1 β, IL-2, IL-5, IL-6, IL-8, IL-12P70, IL-17, TNF-α, IFN-γ, IFN-α) increased, while the secretion of anti-inflammatory cytokines (IL-4, IL-10) decreased in CHB, LC and HCC. The liver damage caused