肝硬化相关肝性脑病患者血清中IL-6、IL-18与血氨水平的相关性分析

张素媛; 李文雯; 朱娅琪; 李小全

doi:10.16766/j.cnki.issn.1674-4152.002866

肝硬化相关肝性脑病患者血清中IL-6、IL-18与血氨水平的相关性分析

doi: 10.16766/j.cnki.issn.1674-4152.002866

1.
河南省荣军医院检验科，河南新乡 453000
2.
河南大学第一附属医院检验科，河南开封 475001

基金项目:

河南省医学科技攻关计划联合共建项目 LHGJ20190529

详细信息

通讯作者:
张素媛，E-mail：ybkjba@163.com

中图分类号: R575.3 R575.2
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- 被引次数: 0
出版历程
- 收稿日期: 2022-02-18
- 网络出版日期: 2023-04-20

Correlation analysis of serum IL-6, IL-18 and blood ammonia level in patients with hepatic encephalopathy

1.
Department of Clinical Laboratory, Rongjun Hospital of Henan Province, Xinxiang, Henan 453000, China

摘要

摘要: 目的对肝硬化相关肝性脑病(HE)患者临床资料进行收集，回顾性分析HE患者血清白细胞介素6(IL-6)、白细胞介素18(IL-18)水平与血氨水平的相关性。方法选取2019年6月—2021年1月河南省荣军医院住院治疗的肝硬化患者95例，其中单纯肝硬化患者41例设为非HE组，肝硬化合并HE患者54例设为HE组，另选同期该院体检健康人员50例，设为健康组。比较3组患者的血氨水平及血清IL-6、IL-18水平；比较HE组与非HE组临床资料的差异，并采用logistic回归分析法分析HE的危险因素；采用Pearson相关性分析法分析血氨水平与血清中IL-6、IL-18水平的相关性。结果与健康组比较，非HE组、HE组血清IL-6、IL-18水平及血氨水平均升高(均P＜0.05)；HE组血清IL-6、IL-18水平及血氨水平高于非HE组(均P＜0.05)；logistic回归分析显示，血清IL-6、IL-18、总胆红素(TBIL)高，凝血酶原时间(PT)长是肝硬化相关HE的危险因素(均P＜0.05)；Pearson相关性分析显示，血清IL-6与血氨水平呈正相关(r=0.690，P＜0.001，95% CI：0.518~0.808)，IL-18与血氨水平呈正相关(r=0.667，P＜0.001，95% CI：0.487~0.793)。结论血清IL-6、IL-18、TBIL高，PT长均是肝硬化相关HE发生的危险因素，且血清IL-6、IL-18水平与血氨水平均呈正相关。
- 肝性脑病 /
- 肝硬化 /
- 白细胞介素6 /
- 白细胞介素18 /
- 血氨
Abstract: Objective The clinical data of patients with liver cirrhosis-related hepatic encephalopathy (HE) were collected, and the correlation among serum interleukin-6 (IL-6), interleukin-18 (IL-18) and blood ammonia levels in patients with HE was analysed retrospectively. Methods A total of 95 patients with liver cirrhosis were selected in Rongjun Hospital of Henan province from June 2019 to January 2021. Among them, 41 patients with simple liver cirrhosis were set as non-HE group, and 54 patients with liver cirrhosis and HE were set as HE group. Another 50 healthy persons from our hospital were selected as the health group in the same period. The levels of serum ammonia, IL-6 and IL-18 were compared among the three groups. Differences in the clinical data between HE and non-HE groups were compared, and the risk factors of HE were determined by logistic regression analysis. Pearson correlation analysis was used to evaluate the correlation among serum levels of ammonia, IL-6 and IL-18. Results The levels of serum IL-6, IL-18 and blood ammonia in the non-HE and HE groups were higher than those in the healthy group (P < 0.05). The levels of serum IL-6, IL-18 and blood ammonia in the HE group were higher than those in non-HE group (P < 0.05). Logistic regression analysis showed that high serum levels of IL-6, IL-18, total bilirubin (TBIL) and long prothrombin time (PT) were risk factors for cirrhosis-related HE (P < 0.05). Pearson correlation analysis showed that serum IL-6 was positively correlated with serum ammonia level (r=0.690, P < 0.001, 95% CI: 0.518-0.808), and IL-18 was positively correlated with blood ammonia level (r=0.667, P < 0.001, 95% CI: 0.487-0.793). Conclusion High serum levels of IL-6, IL-18, TBIL and long PT are risk factors for hepatocirrhosis-related HE, and serum IL-6 and IL-18 levels are positively correlated with the average level of blood ammonia.
- Liver cirrhosis /
- Hepatic encephalopathy /
- Interleukin 6 /
- Interleukin 18 /
- Blood ammonia

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表 1 3组研究对象性别和年龄比较

Table 1. Comparison of gender and age among three groups

组别	例数	性别[例(%)]		年龄 (x±s，岁)
组别	例数	男性	女性	年龄 (x±s，岁)
健康组	50	24(48.00)	26(52.00)	43.47±12.96
非HE组	41	23(56.10)	18(43.90)	43.84±14.05
HE组	54	29(53.70)	25(46.30)	42.64±14.72
统计量		0.650^a		0.095^b
P值		0.723		0.910
注：^a为χ²值，^b为F值。

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表 2 3组研究对象血清IL-6、IL-18水平与血浆血氨水平比较(x±s)

Table 2. Comparison of serum IL-6, IL-18 levels and plasma ammonia levels among three groups (x±s)

组别	例数	IL-6 (pg/mL)	IL-18 (pg/mL)	血氨浓度 (μmol/L)
健康组	50	5.67±1.69	39.17±5.80	17.19±5.23
非HE组	41	38.43±4.55^a	56.53±6.84^a	39.17±8.05^a
HE组	54	61.62±7.17^ab	87.24±10.06^ab	79.42±10.35^ab
F值		1 570.359	493.030	765.989
P值		＜0.001	＜0.001	＜0.001
注：与健康组比较，^aP＜0.05；与非HE组比较，^bP＜0.05。

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表 3 HE组与非HE组临床资料比较

Table 3. Comparison of clinical data between HE group and non-HE group

项目	HE组 (n=54)	非HE组 (n=41)	统计量	P值
年龄(x±s，岁)	42.64±14.72	43.84±14.05	0.401^a	0.689
性别[例(%)]
男性	29(53.70)	23(56.10)	0.054^b	0.816
女性	25(46.30)	18(43.90)
BMI(x±s)	24.81±2.67	24.63±2.61	0.329^a	0.743
吸烟[例(%)]	17(31.48)	10(24.39)	0.576^b	0.448
饮酒[例(%)]	15(27.78)	11(26.83)	0.011^b	0.918
合并慢性基础性疾病[例(%)]	20(37.04)	16(39.02)	0.039^b	0.843
肝病病程(x±s，年)	3.15±1.57	3.24±1.63	0.272^a	0.786
腹水[例(%)]	17(31.48)	12(29.27)	0.054^b	0.817
ALT(x±s，U/L)	124.56±20.71	126.74±21.15	0.504^a	0.616
AST(x±s，U/L)	94.62±20.43	90.87±22.17	0.854^a	0.395
AKP(x±s，U/L)	104.62±29.17	99.51±20.94	0.951^a	0.344
ALB(x±s，g/L)	29.65±3.54	31.02±3.60	1.855^a	0.067
SCr(x±s，μmol/L)	109.64±12.13	107.18±11.35	1.006^a	0.317
TBIL(x±s，μmol/L)	116.94±13.78	50.14±8.61	27.245^a	＜0.001
BUN(x±s，μmol/L)	8.14±1.06	8.35±1.12	0.933^a	0.353
PT(x±s，s)	25.14±3.15	16.81±2.47	13.976^a	＜0.001
WBC(x±s，×10⁹/L)	6.17±1.84	5.93±1.92	0.618^a	0.538
PLT(x±s，×10⁹/L)	121.54±20.29	119.13±21.50	0.559^a	0.578
Hb(x±s，g/dL)	103.18±17.44	99.53±16.75	1.028^a	0.307
注：^a为t值，^b为χ²值。

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表 4 肝硬化相关HE发生的危险因素logistic回归分析

Table 4. Logistic regression analysis of risk factors for liver cirrhosis related HE

变量	B	SE	Wald χ²	P值	OR值	95% CI
IL-6	1.17	0.514	5.181	0.004	3.222	2.415~4.029
IL-18	0.85	0.326	6.798	0.002	2.340	1.278~3.401
TBIL	1.03	0.214	23.166	＜0.001	2.801	1.715~3.887
PT	0.81	0.201	16.240	＜0.001	2.248	1.645~2.851

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