Ciećko-Michalska Irena, Szczepanek Małgorzata, Cibor Dorota, Owczarek Danuta, Skulina Dariusz, Szczepański Wojciech, Michalski Marek
Klinika Gastroenterologii i Hepatologii Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie.
Przegl Lek. 2006;63(5):249-52.
Estimation if the serum concentration of cytokines: IL-2, IL-4, IL-6, IL-8, IL-10, TNF-alfa and CRP can be useful in the assessment of prognosis in patients with alcoholic hepatitis (ALH) and alcoholic liver cirrhosis (ALC). Attempt to find their correlation with clinical stage and life prognosis in all patients.
We examined 24 patients with alcoholic liver disease, hospitalised in Department of Gastroenterology: 13 male and 11 female at the age 26-72 years. According to clinical symptoms and laboratory tests in 15 of them alcoholic hepatitis (in 9 confirmed by liver biopsy) and in 9 - liver cirrhosis (2 confirmed by liver biopsy) were diagnosed. The interview, physical examination, abdominal ultrasound, biochemical tests and viral tests were performed in all patients. We excluded patients treated with steroids and cytostatics. Serum concentration of cytokines and CRP were established three times during the first week of hospitalisation.
In all patients IL-2 and IL-4 concentration were in a range characteristic for healthy people. There was statistically important correlation between the severe clinical stage and high concentration of serum IL-6 (p<0.000319), IL-8 (p<0.000708), TNF-alfa (p<0.000018) and CRP (p< 0.001611) in patients with ALC. High concentration of serum IL-6, IL-8, TNF-alfa and CRP were correlated with poor prognosis (3 patients with ALC and the highest concentration died). High concentration of IL-6, IL-8, TNF-alfa and CRP were correlated with heavy clinical stage and poor prognosis so their evaluation can be helpful in the assessment of prognosis in patients with ALC and ALH.
评估细胞因子白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)和C反应蛋白(CRP)的血清浓度是否有助于评估酒精性肝炎(ALH)和酒精性肝硬化(ALC)患者的预后。尝试找出它们与所有患者临床分期和生存预后的相关性。
我们检查了24例在胃肠病科住院的酒精性肝病患者:13例男性和11例女性,年龄在26至72岁之间。根据临床症状和实验室检查,其中15例诊断为酒精性肝炎(9例经肝活检确诊),9例诊断为肝硬化(2例经肝活检确诊)。对所有患者进行了访谈、体格检查、腹部超声、生化检查和病毒检测。我们排除了接受类固醇和细胞抑制剂治疗的患者。在住院第一周内三次测定细胞因子和CRP的血清浓度。
所有患者的IL-2和IL-4浓度处于健康人的特征范围内。在ALC患者中,严重临床分期与血清IL-6(p<0.000319)、IL-8(p<0.000708)、TNF-α(p<0.000018)和CRP(p<0.001611)的高浓度之间存在统计学上的显著相关性。血清IL-6、IL-8、TNF-α和CRP的高浓度与预后不良相关(3例ALC且浓度最高的患者死亡)。IL-6、IL-8、TNF-α和CRP的高浓度与严重临床分期和预后不良相关,因此对它们的评估有助于评估ALC和ALH患者的预后。