慢性乙型肝炎患者血清sCD40表达水平与生化指标相关性
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摘要
目的探讨慢性乙型肝炎合并相关疾病患者血清中sCD40的表达情况以及临床上生化指标的相关性。方法选取2012年1月到2016年12月在本院肝病科接受治疗的慢性乙型肝炎住院患者150例为肝病组,并选取90例健康人作为对照,对患者血清中sCD40的表达以及与临床生化指标的相关性进行系统分析。结果肝病组患者和对照组血清sCD40浓度及25%~75%百分位数对比差异有统计学意义(P<0.05);慢性肝炎组中血清sCD40水平与丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)水平呈正相关关系(r=0.57、0.36,P<0.05);肝硬化患者组的血清sCD40的水平与碱性磷酸酶(ALP)呈正相关关系(r=0.78,P<0.05);重型肝炎患者死亡患者血清中sCD40水平(231.52±101.98)pg/m L远高于存活患者(t=2.14,P=0.02);入院之初并发性肝脏疾病患者血清中sCD40水平(236.56±117.45)pg/m L与未有并发性肝脏疾病患者血清中sCD40水平(120.35±82.41)pg/m L相比,差异有统计学意义(P<0.05)。结论在慢性乙型肝炎患者血清中,sCD40呈现出异常高表达状态,sCD40可作为评价肝脏细胞损伤程度的免疫学指标对肝衰竭预后状况进行评估。
Objective To study the expression level of sCD40 in serum of patients with chronic hepatitis B complicated with related diseases and the correlation of clinical biochemical indexes. Methods 150 cases of patients with chronic hepatitis B treated in our hospital hepatology department from January 2012 to December 2016 were selected,and 90 healthy persons were selected as control. The expression of sCD40 level in serum and the correlation with clinical and biochemical indexes were analyzed. Results The serum concentration of sCD40 and the percentage of 25%~75% percentile in liver disease group and control group were significantly different(P<0.05). Serum levels of sCD40 in chronic hepatitis group were positively correlated with ALT and AST(r=0.57,0.36,P<0.05). Serum sCD40 levels in patients with cirrhosis were positively correlated with alkaline phosphatase(ALP)(r=0.78,P<0.05). Among the severe hepatitis patients,the serum levels of sCD40 of the dead cases(231.52±101.98 pg/m L)were significantly higher than those of the survivors(t=2.14,P=0.02). Serum levels of sCD40(236.56 ± 117.45)pg/m L in patients with concurrent liver disease at the beginning of admission were significantly different from those in patients without concurrent liver disease(120.35±82.41)pg/m L(P<0.05). Conclusion In patients with chronic hepatitis B,sCD40 showed abnormally high expression status,and sCD40 could be used to evaluate the degree of liver cell damage and to evaluate the prognosis of liver failure as an immunological indicator.
Objective To study the expression level of sCD40 in serum of patients with chronic hepatitis B complicated with related diseases and the correlation of clinical biochemical indexes. Methods 150 cases of patients with chronic hepatitis B treated in our hospital hepatology department from January 2012 to December 2016 were selected,and 90 healthy persons were selected as control. The expression of sCD40 level in serum and the correlation with clinical and biochemical indexes were analyzed. Results The serum concentration of sCD40 and the percentage of 25%~75% percentile in liver disease group and control group were significantly different(P<0.05). Serum levels of sCD40 in chronic hepatitis group were positively correlated with ALT and AST(r=0.57,0.36,P<0.05). Serum sCD40 levels in patients with cirrhosis were positively correlated with alkaline phosphatase(ALP)(r=0.78,P<0.05). Among the severe hepatitis patients,the serum levels of sCD40 of the dead cases(231.52±101.98 pg/m L)were significantly higher than those of the survivors(t=2.14,P=0.02). Serum levels of sCD40(236.56 ± 117.45)pg/m L in patients with concurrent liver disease at the beginning of admission were significantly different from those in patients without concurrent liver disease(120.35±82.41)pg/m L(P<0.05). Conclusion In patients with chronic hepatitis B,sCD40 showed abnormally high expression status,and sCD40 could be used to evaluate the degree of liver cell damage and to evaluate the prognosis of liver failure as an immunological indicator.
引文
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[15]黄胜,桂亚萍,伍沁芳,等.替比夫定治疗HBe Ag阳性慢性乙肝部分应答患者的疗效观察[J].热带医学杂志,2014,14(12):1585-1587.Huang S,Gui YP,Wu QF,et al.Effects of telbivudine treatment on HBe Ag-positive chronic hepatitis B patient with partial responses for pegylated interferon alfa-2a therapy[J].J Trop Med,2014,14(12):1585-1587.
[16]Refky B,Kotb S,Fady T,et al.Impact of liver cirrhosis due to chronic hepatitis C viral infection on the outcome of ovarian cancer:a prospective study[J].BMC Cancer,2015,15:754.
[17]Papastergiou V,Lombardi R,Mac Donald D,et al.Global epidemiology of hepatitis B virus(HBV)infection[J].Current Hepatology Reports,2015,14(3):171-178.
[2]Zekri Ael-R,Nassar AA,El-Din El-Rouby MN,et al.Disease progression from chronic hepatitis C to cirrhosis and hepatocellular carcinoma is associated with increasing DNA promoter methylation[J].Asian Pac J Cancer Prev,2014,14(11):6721-6726.
[3]Hallager S,Ladelund S,Kjaer M,et al.Hepatocellular carcinoma in patients with chronic hepatitis C and cirrhosis in Denmark:a nationwide cohort study[J].J Viral Hepat,2018,25(1):47-55.
[4]王婧涵,李嘉,赵新颜.慢性乙型肝炎和乙肝肝硬化及原发性肝癌血清肿瘤标志物的检测意义[J].临床和实验医学杂志,2013,12(21):1702-1705.Wang JH,Li J,Zhao XY.The significance of serum tumor markers in patients with chronic hepatitis B infected liver diseases[J].Journal of Clinical and Experimental Medicine,2013,12(21):1702-1705.
[5]中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2010年版)[J].中华内科杂志,2011,50(2):168-179.Chinese Socienty of Hepatology,Chinese Medical Association.Chinese Socienty of Infectious Diseases,Chinese Medical Association.Chronic hepatitis B prevention and treatment guidelines(2010 edition)[J].Chin J Intern Med,2011,50(2):168-179.
[6]中国抗癌协会肝癌专业委员会.原发性肝癌诊断标准[J].中华肝脏病杂志,2000,8(3):135.Chinese Society of Liver Cancer.Diagnostic criteria of primary liver cancer[J].Chin J Hepatol,2000,8(3):135.
[7]Sinn DH,Lee J,Goo J,et al.Hepatocellular carcinoma risk in chronic hepatitis B virus-infected compensated cirrhosis patients with low viral load[J].Hepatology,2015,62(3):694-701.
[8]和海玉,路明亮,黄华,等.GP73在慢性乙型肝炎、肝硬化、原发性肝癌血清及组织中的表达[J].昆明医科大学学报,2016,37(4):41-44.He HY,Lu ML,Huang H,et al.The expression of GP73 in serum and tissues of patients with chronic hepatitis B,liver cirrhosis and primary liver cancer[J].Journal of Kunming Medical University,2016,37(4):41-44.
[9]Aydin M,Aydin S,Bacanli M,et al.Aflatoxin levels in chronic hepatitis B patients with cirrhosis or hepatocellular carcinoma in Balikesir,Turkey[J].J Viral Hepat,2015,22(11):926-935.
[10]Narita Y,Genda T,Tsuzura H,et al.Prediction of liver stiffness hepatocellular carcinoma in chronic hepatitis C patients on interferon-based anti-viral therapy[J].J Gastroenterol Hepatol,2014,29(1):137-143.
[11]雷蔓,何松.慢性乙型肝炎、乙型肝炎肝硬化及原发性肝癌患者HBV-X基因突变分析[J].临床肝胆病杂志,2014,30(6):531-536.Lei M,He S.Study of HBV-X gene mutation among patients with HBV-related chronic hepatitis,liver cirrhosis,and primary liver cancer[J].J Clin Hepatol,2014,30(6):531-536.
[12]Chanthra N,Payungporn S,Chuaypen N,et al.Single nucleotide polymorphisms in STAT3 and STAT4 and risk of hepatocellular carcinoma in Thai patients with chronic hepatitis B[J].Asian Pac J Cancer Prev,2015,16(18):8405-8410.
[13]李干文.核苷类似物联合糖皮质激素治疗高转氨酶慢性乙型肝炎患者的意义[J].热带医学杂志,2014,14(6):798-801.Li GW.Significance of nucleoside analogues combined with glucocorticoid therapy to CHB patient with high transaminase[J].J Trop Med,2014,14(6):798-801.
[14]Aktug Demir N,Kolgelier S,Ozcimen S,et al.Evaluation of the relation between hepatic fibrosis and basic laboratory parameters in patients with chronic hepatitis B fibrosis and basic laboratory parameters[J].Hepat Mon,2014,14(4):e16975.
[15]黄胜,桂亚萍,伍沁芳,等.替比夫定治疗HBe Ag阳性慢性乙肝部分应答患者的疗效观察[J].热带医学杂志,2014,14(12):1585-1587.Huang S,Gui YP,Wu QF,et al.Effects of telbivudine treatment on HBe Ag-positive chronic hepatitis B patient with partial responses for pegylated interferon alfa-2a therapy[J].J Trop Med,2014,14(12):1585-1587.
[16]Refky B,Kotb S,Fady T,et al.Impact of liver cirrhosis due to chronic hepatitis C viral infection on the outcome of ovarian cancer:a prospective study[J].BMC Cancer,2015,15:754.
[17]Papastergiou V,Lombardi R,Mac Donald D,et al.Global epidemiology of hepatitis B virus(HBV)infection[J].Current Hepatology Reports,2015,14(3):171-178.