Li Wei, Li Ning, Wang Rui, Li Qunhui, Wu Hao
Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, China.
Hepatol Int. 2015 Apr;9(2):218-23. doi: 10.1007/s12072-015-9610-8. Epub 2015 Mar 21.
Cytokines have been reported to be involved in the cirrhosis and hepatic encephalopathy (HE). Many aspects on the correlation between minimal HE (MHE) and cytokine levels were still unclear.
Two hundred eighty-nine HBV-infected cirrhotic patients were grouped: non MHE (n = 156), MHE (n = 98) and clinical HE (CHE, n = 213). Another 88 healthy volunteers were included as controls. Clinical and laboratory findings and levels of ten serum cytokines were analyzed.
All tested cytokines were significantly elevated in cirrhotic patients and patients with CHE compared with controls. Statistical analysis showed only IL-6, IFNγ and IL-17a were correlated MHE (all three p < 0.001). Multivariate regression analysis indicated that serum IL-6 and IL-17a levels were independent risk factors for MHE. Moreover, all patients with MHE had IL-17a levels higher than 49 pg/mL, whereas those without MHE had IL-17a levels lower than 49 pg/mL.
IL-6, IFNγ, and IL-17a were correlated with MHE in HBV-infected patients. Two independent risk factors (IL-6, IL-17a) for MHE were identified. Our findings pointed out the crucial roles of cytokines in MHE in HBV-infected patients.
细胞因子已被报道与肝硬化及肝性脑病（HE）有关。关于轻微肝性脑病（MHE）与细胞因子水平之间的相关性，仍有许多方面尚不清楚。
将289例乙肝病毒感染的肝硬化患者分组：非MHE组（n = 156）、MHE组（n = 98）和临床肝性脑病（CHE，n = 213）。另外纳入88名健康志愿者作为对照。分析临床和实验室检查结果以及10种血清细胞因子的水平。
与对照组相比，肝硬化患者和CHE患者中所有检测的细胞因子均显著升高。统计分析显示，只有白细胞介素-6（IL-6）、γ干扰素（IFNγ）和白细胞介素-17a（IL-17a）与MHE相关（三者p均<0.001）。多变量回归分析表明，血清IL-6和IL-17a水平是MHE的独立危险因素。此外，所有MHE患者的IL-17a水平高于49 pg/mL，而无MHE的患者IL-17a水平低于49 pg/mL。
IL-6、IFNγ和IL-17a与乙肝病毒感染患者的MHE相关。确定了MHE的两个独立危险因素（IL-6、IL-17a）。我们的研究结果指出了细胞因子在乙肝病毒感染患者MHE中的关键作用。
