巨细胞病毒性肝炎患儿血清IFN-γ和IL-18水平变化及其与预后的关系探讨

doi:10.3969/j.issn.1672-5069.2021.02.015

Abstract

Abstract: Objective The aim of this study was to investigate the changes of serum interferon-γ (IFN-γ) and interleukin-18 (IL-18) levels in children with cytomegalovirus (CMV) hepatitis and their implications with prognosis.Methods A total of 95 children with CMV hepatitis (including mild hepatitis in 66 and severe hepatitis in 29) and 90 healthy children were recruited in our hospital between January 2017 and June 2019, and children with viral hepatitis were treated with ganciclovir for six weeks. Serum IFN-γ and IL-18 levels were detected by enzyme linked immunosorbent assay. The prognosis of the children with CMV hepatitis was analyzed with the area under ROC (AUC).Results At presentation, serum IFN-γ, IL-18, ALT and bilirubin levels in mild group were(7.7±2.9)mmol/L, (56.9±5.7)pg/L, (69.8±11.3)U/L and (75.4±16.7)μmol/L, and in severe hepatitis children were (16.6±4.1)mmol/L, (89.5±8.3)pg/L, (104.7±13.2)U/L and (235.7±20.4)μmol/L, all significantly higher than 【(2.1±1.1)mmol/L, (33.7±4.9)pg/L, (19.6±3.1)U/L and (8.3±2.7)μmol/L, respectively, P<0.05】 in healthy children; at the end of six week treatment, serum IFN-γ, IL-18, ALT and bilirubin levels in mild hepatitis children were(2.2±0.9)mmol/L, (34.1±5.4)pg/L, (21.2±4.3)U/L and(13.4±4.1)μmol/L, all significantly lower than 【(4.1±0.6)mmol/L, (40.6±7.9)pg/L, (46.5±7.5)U/L and (26.5±3.4)μmol/L, respectively, P<0.05】 in severe group; out of the 95 children with CMV hepatitis, 80 recovered, and 15 didn’t; serum IFN-γ, IL-18, ALT and bilirubin levels in recovered children were significantly lower than those in children with abnormal liver function tests or serum CMV DNA positive (all P<0.05); the sensitivity and specificity of serum IFN-γ level in predicting undesirable outcome of children with CMV hepatitis were 86.7% and 96.3%, and those of serum IL-18 level were 93.3% and 73.8%.Conclusion Serum IFN-γ and IL-18 levels are significantly elevated in children with CMV hepatitis, and the children with CMV hepatitis having an increased serum cytokines might have a bad prognosis.

Key words: Cytomegalovirus hepatitis, Interferon-γ, Interleukin-18, Prognosis, Children

Zhang Weina, Ding Chuangang, Zhao Hongying, et al. Changes of serum IFN-γ and IL-18 levels in children with cytomegalovirus hepatitis[J]. Journal of Practical Hepatology, 2021, 24(2): 208-211.

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Changes of serum IFN-γ and IL-18 levels in children with cytomegalovirus hepatitis

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