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肝硬化患者肝功能与肠道菌群、维生素缺乏及白细胞介素-17A的相关性

Correlation of liver function with intestinal flora, vitamin deficiency and IL-17A in patients with liver cirrhosis.

作者信息

Mou Haijuan, Yang Fengying, Zhou Jianqin, Bao Cuixia

机构信息

Department of Public Health, Yantai Infectious Disease Hospital, Yantai, Shandong 264001, P.R. China.

Outpatient Department, Yantai Infectious Disease Hospital, Yantai, Shandong 264001, P.R. China.

出版信息

Exp Ther Med. 2018 Nov;16(5):4082-4088. doi: 10.3892/etm.2018.6663. Epub 2018 Aug 29.

Abstract

The aim of this study was to investigate the correlation of liver function, intestinal flora, vitamin D and interleukin-17A (IL-17A) levels in patients with liver cirrhosis. A total of 52 patients diagnosed with posthepatitic cirrhosis and admitted into Yantai Infectious Disease Hospital (Yantai, China) from January to December in 2012 (liver cirrhosis group), and 52 patients with chronic hepatitis B (hepatitis group), and 40 healthy volunteers receiving physical examination in the hospital (normal control group) were selected into the study. The liver function, hepatitis B virus (HBV) deoxyribonucleic acid (DNA) level, intestinal flora distribution, vitamin D and IL-17A levels of all patients were detected, and the correlation among them was analyzed via Pearson's analysis. The number of and in hepatitis and liver cirrhosis groups was significantly greater than in the normal control group (P<0.05), but the number of and was significantly decreased (P<0.05); the serum IL-17A levels in hepatitis and liver cirrhosis were obviously higher than that in the normal control group (P<0.05), but the serum vitamin D 25(OH) D and 1,25(OH)2D levels were obviously lower than that in the normal control group (P<0.05). In patients with liver cirrhosis, Enterobacteriaceae was positively correlated with prothrombin time (PT), was positively correlated with alanine aminotransferase and aspartate aminotransferase (AST) levels, was negatively correlated with AST, alkline phosphatase (AKP) and HBV DNA levels, and was negatively correlated with AST level and PT. There was a significant negative correlation between serum IL-17A and total bilirubin in patients with liver cirrhosis, and 25(OH) D was negatively correlated with AST, AKP and HBV DNA levels. In patients with liver cirrhosis, there was significant positive correlation between and IL-17A, and between and 25(OH)D, but other bacteria were not obviously associated with IL-17A and vitamin D. Intestinal flora imbalance, vitamin D deficiency and IL-17A imbalance play an important role in the evolution of liver cirrhosis.

摘要

本研究旨在探讨肝硬化患者肝功能、肠道菌群、维生素D及白细胞介素-17A(IL-17A)水平之间的相关性。选取2012年1月至12月在烟台市传染病医院(中国烟台)确诊为肝炎后肝硬化并入院的52例患者(肝硬化组)、52例慢性乙型肝炎患者(肝炎组)以及40例在该院接受体检的健康志愿者(正常对照组)纳入研究。检测所有患者的肝功能、乙肝病毒(HBV)脱氧核糖核酸(DNA)水平、肠道菌群分布、维生素D及IL-17A水平,并通过Pearson分析方法分析它们之间的相关性。肝炎组和肝硬化组中[具体细菌名称1]和[具体细菌名称2]的数量显著多于正常对照组(P<0.05),但[具体细菌名称3]和[具体细菌名称4]的数量显著减少(P<0.05);肝炎组和肝硬化组血清IL-17A水平明显高于正常对照组(P<0.05),但血清维生素D 25(OH)D和1,25(OH)2D水平明显低于正常对照组(P<0.05)。在肝硬化患者中,肠杆菌科与凝血酶原时间(PT)呈正相关,[具体细菌名称5]与丙氨酸氨基转移酶及天冬氨酸氨基转移酶(AST)水平呈正相关,[具体细菌名称6]与AST、碱性磷酸酶(AKP)及HBV DNA水平呈负相关,[具体细菌名称7]与AST水平及PT呈负相关。肝硬化患者血清IL-17A与总胆红素之间存在显著负相关,25(OH)D与AST、AKP及HBV DNA水平呈负相关。在肝硬化患者中,[具体细菌名称8]与IL-17A之间以及[具体细菌名称9]与25(OH)D之间存在显著正相关,但其他细菌与IL-17A和维生素D无明显关联。肠道菌群失衡、维生素D缺乏及IL-17A失衡在肝硬化的进展中起重要作用。

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