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目的:观察原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)患者治疗前后血清IL-6表达水平,探索其与熊去氧胆酸(Ursodeoxycholic acid,UDCA)疗效的临床相关性。方法:本研究回顾性纳入自2013年-2015年就诊于第四军医大学西京消化病医院的40例新诊断PBC患者,及40例健康对照者。收集PBC患者治疗前后的相关临床资料和血清样本,采用ELISA方法检测患者血清IL-6表达水平,并进一步分析其临床意义。结果:1)治疗前PBC患者血清IL-6表达水平明显高于健康对照者(P<0.001);2)PBC患者在接受UDCA治疗后的第3,6和12个月血清IL-6水平与治疗前相比明显降低(P<0.05),且在第3个月时下降最明显。3)无论是依据Paris I标准还是Barcelona标准,结果显示,UDCA应答者与应答不佳者相比其治疗前血清IL-6水平无统计学差异(P=0.373;P=0.409)。但UDCA应答者在治疗3个月时其血清IL-6表达水平比治疗前明显下降(P<0.05),而应答不佳者治疗3个月时血清IL-6表达水平与治疗前相比无明显差异(P=0.667;P=0.186)。结论:IL-6可能在PBC发病的免疫机制中发挥着重要的作用。目前尚不能认为PBC患者治疗前血清IL-6表达水平能独立评价UDCA疗效,但是治疗三个月后患者血清IL-6水平下降趋势能够提示PBC患者对UDCA的应答情况。
Objective: To observe the expression of IL-6 in patients with primary biliary cirrhosis (PBC) before and after treatment, and to explore its clinical significance with Ursodeoxycholic acid (UDCA). Methods: This study retrospectively enrolled 40 newly diagnosed PBC patients and 40 healthy controls who visited the Xijing digestive disease hospital of the Fourth Military Medical University from 2013 to 2015. The clinical data and serum samples of PBC patients before and after treatment were collected. The serum IL-6 level was detected by ELISA, and its clinical significance was further analyzed. Results: 1) Serum IL-6 levels in PBC patients before treatment were significantly higher than those in healthy controls (P <0.001); 2) Serum IL-6 levels in PBC patients at 3, 6 and 12 months after UDCA treatment were significantly correlated with Compared with before treatment was significantly lower (P <0.05), and the most obvious decline in the third month. 3) Whether based on the Paris I standard or the Barcelona standard, the results showed that there was no significant difference in serum IL-6 level between pre-treatment UDCA responders and those with poor response (P = 0.373; P = 0.409). However, the level of IL-6 in serum of UDCA responders significantly decreased at 3 months (P <0.05), but the level of IL-6 in serum of patients with poor response was significantly lower than that before treatment Significant difference (P = 0.667; P = 0.186). Conclusion: IL-6 may play an important role in the pathogenesis of PBC. At present, it can not be considered that the serum IL-6 level before treatment in PBC patients can independently evaluate the efficacy of UDCA. However, the decrease of serum IL-6 level in patients after 3 months of treatment can indicate the response to UDCA in PBC patients.