Study On The Relationship Between Therapeutic Effect And Prognosis Of Serum Interleukin-1 Receptor Antagonist In Patients With Liver Failure

Objective To investigate the therapeutic effect and prognosis of interleukin-1receptor antagonist and interleukin-1 beta in patients with liver failure.Methods A total of 40 cases of patients with liver failure in the first affiliated hospital of Bengbu medical college were selected from March to November in 2016.16 cases were treated with pure drug,and 24 cases were treated with artificial liver support system.Peripheral venous blood were collected in the next day before treatment,during artificial liver treatment and after one week drug treatment,Concentration of IL-1Ra and IL-1 beta was detected by enzyme-linked immunosorbent assay(ELISA).According to the condition of leaving hospital and followed up for 3-6 months,the patients were divided into improved group(including cure patients)and invalid group(including the death of patients),while 13 cases were improved group,27 cases were invalid.The experimental data were processed by SPSS17.0 statistical software,measurement data conforms to normal distribution by using two sample t test,Non-accord with normal distribution using rank sum test.Count data used by X2 test;Cox regression models used to analyze the risk factors influencing the prognosis;correlation analysis by linear regression.The difference was statistically significant(P < 0.05).Results Before treatment,the concentration of IL-1Ra in the improvement group was 47.98±16.66pg/ml,while the concentration of IL-1Ra in the invalid group was34.14 ± 13.66pg/ml,the concentration of IL-1Ra in the improved group was significantly higher than the invalid group(P < 0.05);the improvement group of IL-1 beta concentration was 38.07±10.33pg/ml,the invalid group was 48.02±15.59pg/ml,and IL-1 beta was significantly lower than the invalid group(P < 0.05);IL-1Ra/IL-1beta ratio in the improved group was 1.256±0.213,while IL-1Ra/IL-1 beta ratio was0.743±0.236 in the invalid group,the difference was statistically significant.Linear regression analysis showed that IL-1Ra was positively correlated with CHE and ALB,and negatively correlated with TBIL,PT,INR,and IL-1 was positively correlated with TBIL,Scr,PT,MELD score,and negatively correlated with PTA.We compared with the level of IL-1Ra as well as IL-1 beta before and after treatment,improved group were significantly decreased(P < 0.05),but there was no significant difference between the ratio(P > 0.05);IL-1Ra,IL-1 levels and their ratio in invalid group were not significant difference before and after treatment(P > 0.05).After three artificial liver treatment and drug treatment in two weeks,the concentrations of IL-1Ra and IL-1 beta had not changed dramatically in improved group(P > 0.05),but the ratio was significantly increased(P < 0.05);the concentration of IL-1Ra,IL-1 beta and ratio in invalid group were not significant difference(P > 0.05);Cox regression analysis showed that the concentration of IL-1 beta and hepatorenal syndrome were independent factors affecting the prognosis of liver failure.The ratio of IL-1 ra/IL-1beta was the protection factors.The improvement rate in the artificial liver treatment group was 45.8%,while the pure drug treatment group was 12.5%.Conclusions: 1.The alteration of IL-1Ra,IL-1 and the disorder of proportion are closely related to the occurrence,development and prognosis of liver failure.IL-1Ra is relatively insufficient to limit the immune inflammatory response induced by IL-1beta,which can cause severe liver damage.2.IL-1 beta,IL-1Ra/IL-1 beta ratio and hepatorenal syndrome were independent factors affecting the prognosis of liver failure.3.The artificial liver treatment could improve the prognosis by removing the inflammatory cytokines and restoring the balance of cytokines.