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目的:探讨同为HBsAg阳性、HBeAg阳性和HBV DNA高复制,抗HBc阳性与抗HBc阴性的慢性乙肝患者外周血白细胞介素18(IL18)水平与ALT的相关性,及其临床价值。方法:采用酶联免疫吸附试验(ELISA)测定血清IL18水平。把患者分为抗HBc阳性组和抗HBc阴性组,进行乙型肝炎病毒标志物(HBVM)、HBV DNA定量、ALT和IL18水平测定。结果:两组HBV DNA复制差异无显著性(P>0.05);血清ALT活性抗HBc阳性组显著高于抗HBc阴性组(P<0.01);两组血清IL18水平显著高于对照组(P<0.01),抗HBc阳性组显著高于抗HBc阴性组(P<0.01);血清IL18水平与ALT呈显著正相关(r=0.601,P<0.01)。结论:IL18可能参与了乙型肝炎的炎性损伤过程,血清IL18可作为判定乙型肝炎免疫状态及活动性监测的一项指标,对指导治疗和预后具有一定的临床价值。
Objective: To investigate the correlation between the level of interleukin-18 (IL-18) and ALT in patients with chronic hepatitis B who are positive for HBsAg, positive for HBeAg and have high replication of HBV DNA, anti-HBc positive and anti-HBc negative, and their clinical value. Methods: Serum IL18 levels were measured by enzyme-linked immunosorbent assay (ELISA). Patients were divided into anti-HBc-positive group and anti-HBc-negative group, and hepatitis B virus markers (HBVM), HBV DNA quantification, ALT and IL18 levels were determined. Results: There was no significant difference in HBV DNA replication between the two groups (P> 0.05). Serum ALT activity in anti - HBc positive group was significantly higher than that in anti - HBc negative group (P <0.01). Serum IL18 levels in both groups were significantly higher than those in control group (P < 0.01). The anti-HBc positive group was significantly higher than anti-HBc negative group (P <0.01). Serum IL18 level was positively correlated with ALT (r = 0.601, P <0.01). CONCLUSION: IL18 may be involved in the process of inflammatory injury of hepatitis B, and serum IL18 may be used as an indicator to judge the immune status and activity of hepatitis B. It has certain clinical value in guiding the treatment and prognosis.