摘要
目的探讨慢性乙型肝炎患者乙型肝炎病毒(HBV)DNA载量及血清白细胞介素-2受体(IL-2R)、高尔基体蛋白73(GP73)、微小RNA-21(miR-21)与乙型肝炎病毒血清标志物(HBVM)表达模式、肝组织病理学改变的相关性。方法回顾性选取2020年1月至2022年12月四川绵阳四0四医院(绵阳市第一人民医院)收治的106例慢性乙型肝炎患者作为观察组,另纳入本院125名同期健康体检者为对照组。观察组根据肝脏炎症程度分为炎症较轻组(G_(0)~G_(2)期,n=61)和炎症较重组(G_(3)~G_(4)期,n=45);根据肝纤维化程度分为纤维化较轻组(S_(0)~S_(2)期,n=80)和纤维化较重组(S_(3)~S_(4)期,n=26);根据外周血中是否产生乙肝表面抗体(抗-HBs)分为抗-HBs阳性组(n=77)和抗-HBs阴性组(n=29)。比较观察组与对照组血清IL-2R、GP73、miR-21水平,比较不同肝脏炎症程度、不同肝脏纤维化程度、不同HBVM表达模式的慢性乙型肝炎患者HBV DNA载量、血清IL-2R、GP73、miR-21水平,并采用Spearman相关性分析分析HBV DNA载量、血清IL-2R、GP73、miR-21与肝组织病理学改变的相关性。结果观察组血清IL-2R、GP73、miR-21水平分别为(559.65±46.65)U/mL、(149.87±31.65)ng/mL、1.98±0.65,均高于对照组[(272.54±28.65)U/mL、(48.76±9.65)ng/mL、1.23±0.36],差异均有统计学意义(P<0.05)。炎症较重组HBV DNA载量、血清IL-2R、GP73、miR-21水平分别为(5.98±0.73)loads、(703.54±57.54)U/mL、(243.65±38.65)ng/mL、1.99±0.54,均高于炎症较轻组[(4.65±0.68)loads、(450.65±36.65)U/mL、(80.43±20.34)ng/mL、1.54±0.45],差异均有统计学意义(P<0.05)。纤维化较重组HBV DNA载量、血清IL-2R、GP73、miR-21水平分别为(6.03±0.98)loads、(675.65±58.04)U/mL、(189.65±41.65)ng/mL、2.34±0.34,均高于纤维化较轻组[(4.48±0.79)loads、(522.65±31.54)U/mL、(135.76±26.54)ng/mL、1.31±0.28],差异均有统计学意义(P<0.05)。抗-HBs阳性组和抗-HBs阴性组HBV DNA载量、血清IL-2R、GP73、miR-21水平比较,差异均无统计学意义(P>0.05)。HBV DNA载量、血清IL-2R、GP73、miR-21均与肝脏炎症程度呈正比(r=0.546、0.498、0.657、0.508,P<0.05),与肝脏纤维化程度呈正比(r=0.487、0.506、0.673、0.703,P<0.05)。结论慢性乙型肝炎患者血清中IL-2R、GP73、miR-21表达较高,且患者HBV DNA载量、血清IL-2R、GP73、miR-21水平与肝脏炎症及纤维化程度呈正比,但其与HBVM表达模式无明显相关性。
Objective To exploe the correlation between hepatitis B virus(HBV)DNA load,serum interleukin-2 receptor(IL-2R)and golgi body protein 73(GP73),microRNA-21(miR-21),expression patterns of hepatitis B virus serum markers(HBVM),pathological changes in liver tissue in patients with chronic hepatitis B.Methods A total of 106 patients with chronic hepatitis B admitted to Mianyang 404 Hospital(Mianyang First People's Hospital)from January 2020 to December 2022 were retrospectively selected as the observation group,and 125 healthy individuals who underwent physical examinations during the same period in the same hospital were included as the control group.According to the degree of liver inflammation,the observation group was divided into the milder inflammation group(G_(0)-G_(2)phase,n=61)and the more severe inflammation group(G_(3)-G_(4)phase,n=45);according to the degree of liver fibrosis,the observation group was divided into the less fibrotic group(S_(0)-S_(2)stage,n=80)and the more fibrotic group(S_(3)-S_(4)stage,n=26);according to whether hepatitis B surface antibodies(anti-HBs)produced in the peripheral blood,the observation group was divided into the anti HBs positive group(n=77)and the anti HBs negative group(n=29).The levels of serum IL-2R,GP73,and miR-21 between two groups,as well as the HBV DNA load,serum IL-2R,GP73,and miR-21 levels in patients with different degrees of liver inflammation,fibrosis,and HBVM expression patterns were compared.And the correlation between HBV DNA load,serum IL-2R,GP73,and miR-21 and liver histopathological changes were analyzed by Spearman correlation.Results The levels of serum IL-2R,GP73,and miR-21 in the observation group were(559.65±46.65)U/mL,(149.87±31.65)ng/mL,1.98±0.65,respectively,which were higher than those in the control group[(272.54±28.65)U/mL,(48.76±9.65)ng/mL,1.23±0.36],the differences were statistically significant(P<0.05).The recombinant HBV DNA load,levels of serum IL-2R,GP73,and miR-21 in the more severe inflammation group were(5.98±0.73)loads,(703.54±57.54)U/mL,(243.65±38.65)ng/mL,1.99±0.54,respectively,which higher than those in the milder inflammation group[(4.65±0.68)loads,(450.65±36.65)U/mL,(80.43±20.34)ng/mL,1.54±0.45],the differences were statistically significant(P<0.05).The recombinant HBV DNA load,levels of serum IL-2R,GP73,and miR-21 in the more fibrotic group were(6.03±0.98)loads,(675.65±58.04)U/mL,(189.65±41.65)ng/mL,2.34±0.34,respectively,which were higher than those in the less fibrosis group[(4.48±0.79)loads,(522.65±31.54)U/mL,(135.76±26.54)ng/mL,1.31±0.28],the differences were statistically significant(P<0.05).There were no statistically significant difference in HBV DNA load,levels of serum IL-2R,GP73,and miR-21 between the anti HBs positive group and the anti HBs negative group(P>0.05).The HBV DNA load,serum IL-2R,GP73,and miR-21 were all positively correlated with the degree of liver inflammation(r=0.546,0.498,0.657,0.508,P<0.05),and positively correlated with the degree of liver fibrosis(r=0.487,0.506,0.673,0.703,P<0.05).Conclusion The expression of IL-2R,GP73,and miR-21 in the serum of patients with chronic hepatitis B was high,and the HBV DNA load,levels of serum IL-2R,GP73,and miR-21 were directly proportional to the degree of liver inflammation and fibrosis.Clinically,pathological changes in liver tissue could be predicted based on this,but it is not significantly correlated with the expression pattern of HBVM.
作者
李述美
刘冰
彭思璐
刘仁伟
李铃
孙宏
LI Shu-mei;LIU Bing;PENG Si-lu(Clinical Medicine School of Southwest Medical University,Luzhou Sichuan 646000,China;Department of Infectious Diseases,Mianyang 404 Hospital(Mianyang First People's Hospital),Mianyang Sichuan 621000,China)
出处
《临床和实验医学杂志》
2024年第10期1017-1021,共5页
Journal of Clinical and Experimental Medicine
基金
四川省卫生和计划生育委员会科研课题项目(编号:18PJ342)。
