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目的研究血清白细胞介素33(IL-33)/ST2在慢性HBV感染者中的表达特征及其与疾病严重程度的关系。方法筛选并纳入2013年1月至2016年12月瑞金医院感染科收治的慢性HBV感染者105例,其中乙型肝炎相关慢加急性肝衰竭(HBV-ACLF)组46例,慢性乙型肝炎(CHB)组59例,另纳入健康对照(HC)组20名。其中CHB均行肝穿刺活检,根据肝脏病理学Ishak评分分为4个亚组,分别为无或轻度肝纤维化F0-2组(n=12)、中度肝纤维化F3-4组(n=12)、重度肝纤维化F5组(n=12)及肝硬化F6组(n=23)。ELISA法检测患者外周血清IL-33和sST2的表达水平,与病情严重程度进行相关性分析。结果 CHB组中肝硬化F6亚组sST2水平为(21.3±4.7)ng/mL,明显高于F5亚组、F3-4亚组、F0-2亚组[(5.1±0.8)ng/mL、(5.6±0.8)ng/mL、(3.8±0.4)ng/mL,均P<0.05]及HC组[(6.9±0.7)ng/mL,P<0.05],但低于HBV-ACLF组[(63.5±3.9)ng/mL,P<0.01]。所有患者的血清sST2水平与天门冬氨酸氨基转移酶(AST)、总胆红素(TBil)水平呈正相关(均P<0.05),与血清白蛋白、血小板水平呈负相关(均P<0.01),而与丙氨酸氨基转移酶(ALT)水平无显著相关性。血清IL-33水平在各组之间无显著性差异,F6亚组:(4.7±1.0)pg/mL、F5亚组:(4.2±0.7)pg/mL、F3-4亚组:(4.1±1.1)pg/mL、F0-2亚组:(5.4±2.0)pg/mL、HC组:(5.5±0.9)pg/mL、HBV-ACLF组:(5.4±0.5)pg/mL。结论血清sST2表达水平与CHB患者的肝纤维化进展及病情严重程度密切相关,血清IL-33与CHB肝纤维化进程及疾病进展无关。
Objective To study the expression of serum interleukin-33 (IL-33) / ST2 in patients with chronic HBV infection and its relationship with disease severity. Methods A total of 105 patients with chronic HBV infection admitted to Ruijin Hospital from January 2013 to December 2016 were selected and included 46 patients with chronic hepatitis B plus acute liver failure (HBV-ACLF), 46 with chronic hepatitis B 59 cases in CHB group and 20 cases in HC group. The liver biopsies of CHB patients were divided into 4 subgroups according to the Ishak score of liver pathology: F0-2 group without or with mild hepatic fibrosis (n = 12), F3-4 group with moderate hepatic fibrosis (n = 12), severe liver fibrosis F5 group (n = 12) and cirrhosis F6 group (n = 23). Serum levels of IL-33 and sST2 were detected by ELISA, and their correlations were analyzed with the severity of the disease. Results The level of sST2 in cirrhosis F6 subgroup was (21.3 ± 4.7) ng / mL in CHB group, which was significantly higher than that in F5 subgroup, F3-4 subgroup and F0-2 subgroup [(5.1 ± 0.8) ng / mL, ML, (3.8 ± 0.4) ng / mL, all P <0.05] and HC group (6.9 ± 0.7 ng / mL, P <0.05) ± 3.9) ng / mL, P <0.01]. The serum levels of sST2 in all patients were positively correlated with AST and TBil (all P <0.05), but negatively correlated with serum albumin and platelet (all P <0.01 ), But not with the level of alanine aminotransferase (ALT). There were no significant differences in serum IL-33 levels between the groups: F6 subgroup: (4.7 ± 1.0) pg / mL; F5 subgroup: (4.2 ± 0.7) pg / 1.1) pg / mL, F0-2 subgroup: (5.4 ± 2.0) pg / mL, HC group: (5.5 ± 0.9) pg / mL and HBV-ACLF group: (5.4 ± 0.5) pg / mL. Conclusions The serum level of sST2 is closely related to the progression of liver fibrosis and severity of disease in patients with CHB. Serum IL-33 has nothing to do with the progression of liver fibrosis and CHB.