中性粒细胞脂质运载蛋白和细胞因子在DPMAS人工肝治疗肝衰竭中的疗效评估

doi:10.16352/j.issn.1001-6325.2026.10.1402

基础医学与临床 ›› 2026, Vol. 46 ›› Issue (10): 1402-1406.doi: 10.16352/j.issn.1001-6325.2026.10.1402

中性粒细胞脂质运载蛋白和细胞因子在DPMAS人工肝治疗肝衰竭中的疗效评估

郭桂芳¹, 王亮¹, 程晓宇¹, 李明¹, 陈佳丽², 李小鹏^1*

1.南昌大学第一附属医院感染科,江西南昌 330006;
2.江西省儿童医院心脏病中心,江西南昌 330038

收稿日期:2025-08-14 修回日期:2025-12-31 出版日期:2026-10-05 发布日期:2026-09-18
通讯作者: ^*guabishahao8410@163.com
基金资助:
北京肝胆相照公益基金会人工肝专项基金(iGandanF-1082024-RGG030;iGandanF-1082024-RGG110);江西省卫生健康委科技计划项目(202410195)

Human neutrophil lipocalin and cytokines in the efficacy evaluation of DPMAS artificial liver therapy in liver failure

GUO Guifang¹, WANG Liang¹, CHENG Xiaoyu¹, LI Ming¹, CHEN Jiali², LI Xiaopeng^1*

1. Department of Infectious Diseases, First Affiliated Hospital of Nanchang University, Nanchang 330006;
2. Heart Disease Center of Jiangxi Children′s Hospital, Nanchang 330038, China

Received:2025-08-14 Revised:2025-12-31 Online:2026-10-05 Published:2026-09-18
Contact: ^*guabishahao8410@163.com

摘要/Abstract

摘要： 目的探讨中性粒细胞脂质运载蛋白(HNL)及细胞因子如肿瘤坏死因子(TNF-α)、白细胞介素6(IL-6)、白细胞介素1β(IL-1β)在肝衰竭患者接受双重血浆分子吸附系统(DPMAS)人工肝治疗中的动态变化及其对疗效的评估价值。方法选取 2023年1月至2024年12月南昌大学第一附属医院感染科收治的肝衰竭患者167例,根据治疗后 4 周疗效分为有效组(n=132)和无效组(n=35)。检测两组患者治疗前及治疗 1 周、2 周、4 周后的HNL、TNF-α、IL-6、IL-1β 水平,同步检测谷丙转氨酶(ALT)、总胆红素(TBIL)、白蛋白(ALB)、凝血酶原活动度(PTA)、国际标准化比值(INR)。分析HNL和细胞因子与肝功能指标的相关性,评估HNL和细胞因子对 DPMAS 疗效的预测价值。结果有效组治疗后 1 周、2 周、4 周的 HNL、IL-6、TNF-α、IL-1β、ALT、TBIL、INR 水平显著低于治疗前及无效组同期,ALB、PTA 高于治疗前及无效组同期(P＜0.05)。HNL、IL-6、TNF-α、IL-1β与 ALT、TBIL、INR 呈正相关,与 ALB、PTA 呈负相关(P＜0.05)。HNL 联合细胞因子预测 DPMAS 疗效的AUC为 0.956,显著高于各指标单独预测(P＜0.05)。结论 HNL及细胞因子可动态反映 DPMAS 治疗效果,联合检测对肝衰竭疗效评估具有重要临床价值。

关键词: 中性粒细胞脂质运载蛋白, 细胞因子, 肝衰竭, 双重血浆分子吸附系统

Abstract: Objective To explore the dynamic changes of human neutrophil lipocalin (HNL) and cytokines (TNF-α,IL-6, IL-1β) in patients with liver failure undergoing double plasma molecular adsorption system (DPMAS)artificial liver therapy, as well as their value in evaluating treatment efficacy. Methods A total of 167 patients with liver failure admitted to the Department of Infectious Diseases at the First Affiliated Hospital of Nanchang University from January 2023 to December 2024 were selected. They were divided into an effective group (n=132) and an ineffective group (n=35) according to the therapeutic effect 4 weeks after treatment. The levels of HNL, TNF-α,IL-6, and IL-1β were detected in both groups before treatment and at 1 week, 2 weeks, and 4 weeks after treatment. Meanwhile, alanine transaminase (ALT), total bilirubin (TBIL), albumin (ALB), prothrombin activity (PTA), and international normalized ratio (INR) were measured synchronously. The correlation between HNL, cytokines and liver function indicators was analyzed, and the predictive value of HNL and cytokines for the efficacy of DPMAS was evaluated. Results In the effective group, the levels of HNL, IL-6, TNF-α, IL-1β, ALT, TBIL, and INR at 1 week, 2 weeks, and 4 weeks after treatment were significantly lower than those before treatment and in the ineffective group at the same period, while ALB and PTA were significantly higher than those before treatment and in the ineffective group at the same period (P＜0.05). HNL and cytokines were positively correlated with ALT, TBIL, and INR, and negatively correlated with ALB and PTA (P＜0.05). The AUC of HNL combined with cytokines in predicting the efficacy of DPMAS was 0.956, which was significantly higher than that of each index alone(P＜0.05). Conclusions HNL and cytokines can dynamically reflect the therapeutic effect of DPMAS, and their combined detection has important clinical value in evaluating the efficacy of liver failure treatment.

Key words: human neutrophil lipocalin, cytokines, liver failure, double plasma molecular adsorption system

中图分类号:

R575

郭桂芳, 王亮, 程晓宇, 李明, 陈佳丽, 李小鹏. 中性粒细胞脂质运载蛋白和细胞因子在DPMAS人工肝治疗肝衰竭中的疗效评估[J]. 基础医学与临床, 2026, 46(10): 1402-1406.

GUO Guifang, WANG Liang, CHENG Xiaoyu, LI Ming, CHEN Jiali, LI Xiaopeng. Human neutrophil lipocalin and cytokines in the efficacy evaluation of DPMAS artificial liver therapy in liver failure[J]. Basic & Clinical Medicine, 2026, 46(10): 1402-1406.

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中性粒细胞脂质运载蛋白和细胞因子在DPMAS人工肝治疗肝衰竭中的疗效评估

Human neutrophil lipocalin and cytokines in the efficacy evaluation of DPMAS artificial liver therapy in liver failure

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