关键词: 慢加急性肝衰竭, 外周血单个核细胞, 干扰素诱导蛋白-10, 环氧化酶-2, 预后

Abstract: Objective The aim of this study was to explore the changes of interferon-inducible protein -10 (IP-10) and cyclooxygenase-2 (COX-2) in peripheral blood mononuclear cells (PBMCs) in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). Methods 73 patients with HBV-ACLF and 95 patients with chronic hepatitis B (CHB) were enrolled in our hospital between January 2019 and March 2021. The PBMCs were separated from peripheral blood, and the IP-10 and COX-2 mRNA levels were assayed by RT-PCR. Serum HBsAg level was detected by chemiluminescence, and serum IFN-γ level was measured by ELISA. Results Serum IFN-γ, PBMC IP-10 mRNA and COX-2 mRNA levels in patients with HBV-ACLF were (59.3±7.9)ng/L,(0.9±0.1) and (1.6±0.2), all significantly higher than [(35.8±6.2)ng/L, (0.6±0.1) and (0.5±0.1), respectively, P<0.05] in patients with CHB; the PBMC IP-10 and COX-2 levels in patients with HBV-ACLF were negatively correlated to serum HBsAg levels (r=-0.828, P<0.05; r=-0.795, P<0.05); serum IFN-γ, PBMC IP-10 mRNA and COX-2 mRNA in 29 dead patients with ACLF were (67.5±8.1)ng/L, (1.2±0.2) and (1.9±0.4), much higher than [(53.9±7.4)ng/L, (0.7±0.1) and (1.4±0.2), respectively, P<0.05] in 44 survivals; the AUCs were 0.835 and 0.828, as the PBMC IP-10 and COX-2 levels were applied to predict the prognosis of patients with HBV-ACLF, not significantly different (P>0.05); the 90-day survival was 46.9% in 32 patients with PBMC IP-10 mRNA≥0.9, much lower than 70.7%(P<0.05) in 41 patients with IP-10 mRNA＜0.9, and the 90-day survival was 47.4% in 38 patients with COX-2 mRNA≥1.7, much lower than 74.3%(P<0.05) in 35 patients with COX-2 mRNA<1.7. Conclusion The PBMC IP-10 and COX-2 mRNA levels in patients with HBV-ACLF are greatly increased, which might hint a poor prognosis, and needs further investigation.

Key words: Acute-on-chronic liver failure, Peripheral blood mononuclear cells, Interferon-inducible protein-10, Cyclooxygenase-2, Prognosis