[1]刘昌贺,李　衡,徐圣杰,等.肝硬化伴肝性脑病与血清IL-6表达水平相关性的meta分析[J].现代检验医学杂志,2022,37(03):56-61.[doi:10.3969/j.issn.1671-7414.2022.03.012]
　LIU Chang-he,LI Heng,XU Sheng-jie,et al.Meta Analysis of the Correlation between Serum Interleukin-6 and Hepatic Encephalopathy in Liver Cirrhosis[J].Journal of Modern Laboratory Medicine,2022,37(03):56-61.[doi:10.3969/j.issn.1671-7414.2022.03.012]
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肝硬化伴肝性脑病与血清IL-6表达水平相关性的meta分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第37卷
期数:
2022年03期
页码:
56-61
栏目:
论　著
出版日期:
2022-05-15

文章信息/Info

Title:
Meta Analysis of the Correlation between Serum Interleukin-6 and Hepatic Encephalopathy in Liver Cirrhosis
文章编号:
1671-7414（2022）03-056-07
作者:
刘昌贺1; 2; 李　衡1; 徐圣杰1; 郭晶晶3; 吴清华1; 2
(1. 贵州医科大学, 贵阳 550004；2. 江南大学附属医院, 江苏无锡 214062；3. 南通大学医学院, 江苏南通 226001)
Author(s):
LIU Chang-he1; 2;  LI Heng1;  XU Sheng-jie1;  GUO Jing-jing3; WU Qing-hua1; 2
（1. Guizhou Medical University, Guiyang 550004, China；2. Affiliated Hospital of Jiangnan University, Jiangsu Wuxi 214062, China；3.Medical College of Nantong University, Jiangshu Nantong 226001，China）
关键词:
血清白细胞介素-6; 肝硬化; 肝性脑病; Meta 分析
分类号:
R575.2；R392.11
DOI:
10.3969/j.issn.1671-7414.2022.03.012
文献标志码:
A
摘要:
目的　评价肝硬化伴肝性脑病（ hepatic encephalopathy，HE）与血清白细胞介素 -6（serum interleukin-6， sIL-6）水平表达的关系。方法　计算机检索中国生物医学文献（ CBM）、知网（ CNKI）、维普 (VIP)、万方 (WAN FANG)，PubMed，Embase，Web of Science和 Cochrane Library数据库，搜集肝硬化患者中关于 sIL-6水平与 HE相关的病例对照研究，检索时间均为建库至 2021年 4月。根据纳入和排除标准，最终纳入 13个研究，包括 1 479例研究对象，采用 Review Manager Version 5.3进行 meta分析。结果　sIL-6的含量在肝硬化伴 HE组与肝硬化无 HE组比较 [SMD=1.29,95%CI（0.51，2.08），P=0.001]，肝硬化伴显性肝性脑病（ overt hepatic encephalopathy，OHE）组与肝硬化无 HE组比较 [SMD=2.77,95%CI(1.64，3.89），P＜ 0.000 01]，肝硬化伴轻微肝性脑病（ minimal hepatic encephalopathy, MHE）组与肝硬化无 HE组比较 [SMD=2.82,95%CI（1.05，4.58），P=0.002]，肝硬化伴 OHE与肝硬化伴 MHE组比较 [SMD=1.82,95%CI(1.30，2.33），P＜ 0.000 01]，肝硬化伴Ⅲ～Ⅳ级 HE组与肝硬化伴Ⅰ～Ⅱ级 HE组比较 [SMD=0.95,95%CI(0.52，1.37），P＜ 0.000 1]，肝硬化伴 MHE与健康对照组比较 [SMD=4.32,95%CI(2.86，5.77）， P＜ 0.000 01]，肝硬化无 HE组与健康对照组比较 [SMD=2.23,95%CI（1.34，3.12），P＜ 0.000 01]，差异均有统计学意义。结论　sIL-6的表达水平可能与肝性脑病的发病机制有关，有望成为诊断肝性脑病及判定预后疗效的重要炎症指标，还需要更多高质量、多中心的研究验证。
Abstract:
Objective　To evaluate the relationship between Hepatic encephalopathy (HE) and serum interleukin-6 (sIL-6) in liver cirrhosis. Methods　Computer retrieval of CBM, CNKI, VIP, WanFang, PubMed, Embase, Web of Science and Cochrane Library database were conducted to retrieve case-control studies related to sIL-6 level and HE. The retrieval time was from the establishment of the database to April 2021. According to inclusion and exclusion criteria, 13 studies were included, including 1 479 subjects, and meta-analysis was performed using Review Manager Version 5.3. Results　The levels of sIL-6 were compared between liver cirrhosis with HE group and liver cirrhosis without HE group[SMD=1.29, 95%CI（0.51，2.08）, P=0.001]. Comparison between cirrhosis with OHE group and cirrhosis without HE group[SMD=2.77, 95%CI(1.64，3.89）, P ＜ 0.000 01]. Comparison of cirrhosis with MHE group and cirrhosis without HE group[SMD=2.82, 95%CI（1.05，4.58）, P=0.002]. Cirrhosis with OHE group and cirrhosis with MHE group[SMD=1.82,95%CI(1.30, 2.33）, P ＜ 0.000 01]. Comparison of cirrhosis with grade Ⅲ～Ⅳ HE group and cirrhosis with grade Ⅰ～Ⅱ HE group[SMD=0.95,95%CI(0.52，1.37）, P ＜ 0.000 1]. Comparison of cirrhosis with MHE group and Healthy control group[SMD=4.32, 95%CI(2.86，5.77）, P ＜ 0.000 01]. Comparison of liver cirrhosis without HE group and healthy control group[SMD=2.23, 95%CI（1.34，3.12）, P ＜ 0.000 01], the differences among the above groups were statistically significant. Conclusion　The increase of sIL-6 may be related to the pathogenesis of hepatic encephalopathy. It is expected to be an important inflammatory indicator for diagnosing hepatic encephalopathy and determining its prognosis. However, more high-quality and multi-center studies are needed to verify the level of sIL-6.

参考文献/References:

[1] WIJDICKS E F. Hepatic encephalopathy[J]. The New England Journal of Medicine, 2016, 375(17): 1660-1670.
[2] PATIDAR K R, BAJAJ J S. Covert and overt hepatic encephalopathy: diagnosis and management[J]. Clinical Gastroenterology and Hepatology, 2015, 13(12): 2048-2061.
[3] RINCON M. Interleukin-6: From an inflammatory marker to a target for inflammatory diseases[J]. Trends in Immunology, 2012, 33(11): 571-577.
[4] LABENZ C, TOENGES G, HUBER Y, et al. Raised serum interleukin-6 identifies patients with liver cirrhosis at high risk for overt hepatic encephalopathy[J]. Alimentary Pharmacology & Therapeutics, 2019, 50(10): 1112-1119.
[5] 王柯尹, 吴一鸣, 陆许贞, 等．乙型肝炎肝硬化合并 肝性脑病患者血清LPS, TNF-α 和IL-6 的表达变化 及意义[J]. 中国现代医生,2017,55(10):12-15. WANG Keyin, WU Yiming, LU Xuzhen, et al. Changes of expression of serum LPS, TNF-α and IL-6 in patients with hepatitis B-related cirrhosis complicated with hepatic encephalopathy and its significance [J]. China Modern Doctor,2017,55(10):12-15.
[6] 柳萍飞, 包健. 亚临床肝性脑病患者肠道菌群和血 清炎症因子水平变化及益生菌的干预作用[J]. 中国 微生态学杂志, 2020, 32(2):180-182, 186. LIU Pingfei, BAO Jian. Changes of intestinal flora and serum inflammatory factor levels of patients with subclinical hepatic encephalopathy and the intervention effect of probiotics [J]. Chinese Journal of Microecology, 2020,32(2):180-182, 186.
[7] 张靖, 张厚亮．肝硬化致肝性脑病患者血氨与血清 白细胞介素-6 水平相关性分析[J]．医学理论与实践, 2017, 30(8): 1204-1206. ZHANG Jing, ZHANG Houliang. Correlation analysis of serum ammonia and serum interleukin-6 levels in patients with hepatic encephalopathy caused by cirrhosis[J].The Journal of Medical Theory and Practice,2017,30(8):1204-1206.
[8] 刘冀川．慢性HE 患者肠道细菌种类与血清炎性因 子相关性分析[J]. 检验医学,2018,33(10):907-912. LIU Jichuan. Correlation of the kinds of gut bacteria with serum inflammatory cytokines in patients with chronic HE[J].Laboratory Medicine, 2018,33(10):907-912.
[9] 金军, 宋震宇, 刘吉祥. 乙型肝炎肝硬化患者血 清IL-10 和可溶性细胞间黏附分子-1 水平及其对 疾病预后的判断价值[J]. 实用肝脏病杂志, 2019, 22(4):549-552. JIN Jun, SONG Zhenyu, LIU Jixiang. Changes of serum IL-10 and soluble intercellular adhesion molecule-1 levels in patients with hepatitis B-induced liver cirrhosis [J]. Journal of Practical Hepatology,2019,22(4):549-552.
[10] TSAI C F, CHU C J, HUANG Y H, et al. Detecting minimal hepatic encephalopathy in an endemic country for hepatitis B:the role of psychometrics and serum IL- 6[J]. PLoS One, 2015, 10(6): e0128437.
[11] EL-ATTY E A,SHAYEB E, SONBOL E R, et al. Study of interleukin-6 and its role in hepatic encephalopathy in patients with liver cirrhosis [J]. Menoufia Medical Journal, 2019, 32(3):906.
[12] MONTOLIU C, PIEDRAFITA B, SERRA M A, et al. IL-6 and IL-18 in blood may discriminate cirrhotic patients with and without minimal hepatic encephalopathy[ J]. Journal of Clinical Gastroenterology, 2009, 43(3): 272-279.
[13] LUO Ming, LI Lei, YANG Er’na, et al. Correlation between interleukin-6 and ammonia in patients with overt hepatic encephalopathy due to cirrhosis[J]. Clinics and Research in Hepatology and Gastroenterology, 2013, 37(4): 384-390.
[14] BAJAJ J S, HYLEMON P B, RIDLON J M, et al. Colonic mucosal microbiome differs from stool microbiome in cirrhosis and hepatic encephalopathy and is linked to cognition and inflammation[J]. American Journal of Physiology-Gastrointestinal and Liver Physiology, 2012, 303(6): G675-G685.
[15] FELIPO V, URIOS A, MONTESINOS E, et al. Contribution of hyperammonemia and inflammatory factors to cognitive impairment in minimal hepatic encephalopathy[J]. Metabolic Brain Disease, 2012, 27(1): 51-58.
[16] YADAV S K, GOEL A, SARASWAT V A, et al. Evaluation of cognitivity, proinflammatory cytokines, and brain magnetic resonance imaging in minimal hepatic encephalopathy induced by cirrhosis and extrahepatic portal vein obstruction[J]. Journal of Gastroenterology and Hepatology, 2016, 31(12): 1986- 1994.
[17] LUO Ming, LI Lei, YANG Er’na,, et al. Relationship between interleukin-6 and ammonia in patients with minimal hepatic encephalopathy due to liver cirrhosis[J]. Hepatology Research, 2012, 42(12): 1202-1210.
[18] KRISHNARAO A, GORDON F D. Prognosis of hepatic encephalopathy[J].Clinics in Liver Disease, 2020, 24(2): 219-229.
[19] CHACKO K R, SIGAL S H. Update on management of patients with overt hepatic encephalopathy[J]. Hospital Practice (1995), 2013, 41(3): 48-59.
[20] 黄小兵, 冯丽春, 覃志坚．肝病患者血氨含量的变 化及其临床意义探讨[J]. 现代检验医学杂志, 2002, 17(2):7-8. HUANG Xiaobin, FENG Lichun, QIN Zhijian. The clinical study of the changes in blood ammonia concentration in patients with hepatic diseases [J].Journal of Modern Laboratory Medici ne,2002,17(2):7-8.
[21] ROLANDO N, WADE J, DAVALOS M, et al. The systemic inflammatory response syndrome in acute liver failure[J]. Hepatology (Baltimore, Md.),2000,32(4Pt1): 734-739.
[22] SHAWCROSS D L, DAVIES N A, WILLIAMS R, et al. Systemic inflammatory response exacerbates the neuropsychological effects of induced hyperammonemia in cirrhosis[J]. Journal of Hepatology, 2004, 40(2): 247-254.
[23] 李梦羽, 周希乔. 肝性脑病发病机制的研究进展[J]. 胃肠病学, 2020, 25(2):116-120. LI Mengyu, ZHOU Xiqiao. Research progress on pathogenesis of hepatic encephalopathy [J]. Chinese Journal of Gastroenterology, 2020, 25(2): 116-120.
[24] YANG Zhaohui, PENG Yulong, YANG Suxian. MicroRNA-146a regulates the transformation from liver fibrosis to cirrhosis in patients with hepatitis B via interleukin-6[J]. Experimental and Therapeutic Medicine, 2019, 17(6): 4670-4676.
[25] HSIEH C C, HUNG C H, CHIANG M, et al. Hepatic stellate cells enhance liver cancer progression by inducing Myeloid-Derived suppressor cells through interleukin-6 signaling[J]. International Journal of Molecular Sciences, 2019, 20(20): 5079.
[26] 耿彪, 宋婷阁, 张鹏举, 等. 血清炎症因子与老年急 性脑梗死颈动脉粥样硬化及预后的关系[J]. 现代检 验医学杂志, 2019, 34(4):120-123, 127. GENG Biao, SONG Tingge, ZHANG Pengju, et al. Relationship between flammatory factors in serum and carotid atherosclerosis and prognosis in elderly patients with acute cerebral infarction [J]. Journal of Modern Laboratory Medicine,2019,34(4):120-123, 127.
[27] ABDELAZIZ R R, ELKASHEF W F, SAID E. Tranilast reduces serum IL-6 and IL-13 and protects against thioacetamide-induced acute liver injury and hepatic encephalopathy[J]. Environmental Toxicology and Pharmacology, 2015, 40(1): 259-267.
[28] BARAKA S M, SALEH D O, GHALY N S, et al. Flavonoids from Barnebydendron riedelii leaf extract mitigate thioacetamide-induced hepatic encephalopathy in rats: The interplay of NF-κB/IL-6 and Nrf2/HO-1 signaling pathways[J]. Bioorganic Chemistry, 2020, 105(2014): 104444.
[29] HERN?NDEZ-RABAZA V, CABRERA-PASTOR A, TAORO-GONZ?LEZ L, et al. Hyperammonemia induces glial activation, neuroinflammation and alters neurotransmitter receptors in hippocampus, impairing spatial learning: reversal by sulforaphane[J]. Journal of Neuroinflammation, 2016, 13(1): 41.
[30] BRITO-AZEVEDO A, PEREZ R M, MARANH?O P A, et al. Organ dysfunction in cirrhosis: a mechanism involving the microcirculation[J]. European Journal of Gastroenterology & Hepatology, 2019, 31(5): 618-625.

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备注/Memo

备注/Memo:
基金项目：太湖高层次人才项目（编号BJ2020048），无锡市卫健委妇幼科研面上项目（FYKY201902），资助单位：无锡市卫生健康委员会。
作者简介：刘昌贺（1993-），男，在读硕士，住院医师，研究方向：肝性脑病的诊治，E-mail:2421513783@qq.com。
通讯作者：吴清华，男，博士，主任医师，硕士生导师，E-mail:wqhsusan@126.com。
更新日期/Last Update: 1900-01-01