| 张雅菲,徐侠,贾超,等.肝硬化上消化道出血病人血清白细胞介素 -33、血管性假血友病因子水平及其与病情、预后的关系[J].安徽医药,2026,30(8):1622-1626. |
| 肝硬化上消化道出血病人血清白细胞介素 -33、血管性假血友病因子水平及其与病情、预后的关系 |
| Levels of serum interleukin-33 and von willebrand factor in patients with upper gastrointestinal bleeding due to liver cirrhosis and their relationship with disease condition and prognosis |
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| DOI：10.3969/j.issn.1009-6469.2026.08.027 |
| 中文关键词: 上消化道出血 肝硬化 白细胞介素 -33 血管性假血友病因子 病情程度 |
| 英文关键词: Upper gastrointestinal bleeding Cirrhosis Interleukin-33 Vascular von Willebrand factor Disease condition |
| 基金项目:河南省医学科技攻关计划项目( LHGJ20210724) |
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| 中文摘要: |
| 目的探究肝硬化上消化道出血( UGIB)病人血清白细胞介素 -33(IL-33)、血管性假血友病因子( vWF)水平及其与病情、预后的关系。方法前瞻性选取 2018年 3月至 2023年 3月在郑州市第一人民医院确诊的 205例肝硬化病人为研究对象，根据其是否发生 UGIB将其分为 UGIB组(肝硬化并发 UGIB病人， 105例)和非 UGIB组(肝硬化无 UGIB病人， 100例)。收集病人一般资料；酶联免疫吸附分析( ELISA)法检测血清 IL-33、vWF水平；受试者操作特征曲线( ROC曲线)分析预后的诊断价值； logistic多因素回归分析肝硬化 UGIB病人预后的影响因素。结果 UGIB组血清 IL-33为( 132.59±17.68)ng/L、vWF为( 68.35±7.12)μg/L，显著高于非 UGIB组［( 86.43±10.51)ng/L、(42.16±4.75)μg/L］(P<0.05)。 Child-Pugh C级病人血清 IL-33、vWF高于 Child-Pugh A、B级( P<0.05)；重度出血组血清 IL-33、vWF高于中度组及轻度组( P<0.05)。预后不良组血清 IL-33(149.03±13.75)ng/L、vWF(74.87±5.19)μg/L显著高于预后良好组［( 128.48±10.62)ng/L、(65.72±4.35)μg/L］(P<0.05)。血清 IL-33、vWF单独诊断预后不良的曲线下面积( AUC)及其 95%CI分别为 0.83(0.73，0.93)、 0.87(0.78，0.97)联合诊断 AUC及其 95%CI为 0.95(0.90，1.00)联合诊断价值高于单一指标( Z三者联合 -IL-3=2.89、Z三者联合 -vWF=2.12，P<0.05)。 IL-33WF水平升高是肝硬化 UGIB、v，病人预后不良的危，险因素( P<0.05)。结论肝硬化 UGIB病人血清 IL-33、vWF水平升高，且与疾病严重程度及临床预后密切相关，联合检测可作为预后评估的诊断价值。 |
| 英文摘要: |
| Objective To explore the serum levels of interleukin-33 (IL-33) and vascular von Willebrand factor (vWF) in patientswith upper gastrointestinal bleeding (UGIB) due to liver cirrhosis, and their relationship with disease condition and prognosis.Meth. ods Prospective selection of 205 patients with liver cirrhosis diagnosed in Zhengzhou First People's Hospital from March 2018 toMarch 2023 were selected as the research subjects. According to the presence or absence of UGIB, they were divided into a UGIBgroup (cirrhotic patients with UGIB, n=105) and a non-UGIB group (cirrhotic patients without UGIB, n=100). General information of the patients was collected; enzyme-linked immunosorbent assay (ELISA) was applied to detect serum IL-33 and vWF levels; receiveroperating characteristic (ROC) curve was used to evaluate the diagnostic value for prognosis, while multivariate logistic regression usedto identify the prognostic factors in cirrhotic patients with UGIB.Results The serum levels of IL-33 and vWF in the UGIB group were(132.59±17.68) ng/L and (68.35±7.12) μg/L, which were significantly higher than those in the non-UGIB group [(86.43±10.51) ng/L, (42.16±4.75) μg/L] (P<0.05). The serum IL-33 and vWF levels in Child Pugh class C patients were higher than those in Child Pugh class A and class B patients (P<0.05). The serum IL-33 and vWF levels in the severe bleeding group were higher than those in the mod-erate and mild bleeding groups (P<0.05). The serum levels of IL-33 and vWF in the poor prognosis group were significantly higher than those in the good prognosis group [(149.03±13.75) ng/L vs. (128.48±10.62) ng/L, (74.87±5.19) μg/L vs. (65.72±4.35) μg/L] (P<0.05). The area under the curve (AUC) and its 95%CI for diagnosing poor prognosis with serum IL-33 and vWF alone were 0.83 (0.73, 0.93) and 0.87 (0.78, 0.97), respectively. The AUC and its 95%CI for combined diagnosis were 0.95 (0.90, 1.00). The combined diagnostic value was higher than that of any single index (Zcombination of the three-IL-3=2.89, Zcombination of the three-vWF=2.12, P<0.05). Increased levels of IL-33 and vWF were risk factors for poor prognosis in cirrhotic patients with UGIB (P<0.05).Conclusions The levels of serum IL-33 and vWF are elevated in cirrhotic patients with UGIB, which are closely associated with disease severity and prognosis. The combined detectionhas certain diagnostic value for prognostic assessment. |
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