首 页   本刊简介  编委会  审稿专家  在线期刊  写作规范  广告合作  联系我们
您现在的位置:首页 => 在线期刊 => 4期中西医结合肝胆胰疾病 => 其他 =>HBV相关慢加急性肝衰竭患者..
HBV相关慢加急性肝衰竭患者血清M30和CCL20水平变化及意义
Expression of M30 and CCL20 in serum in patients with HBV-related acute-on-chronic liver failure and their clinical significance
文章发布日期:2018年03月07日  来源:  作者:陈海鸥,刘适,林一鹤  点击次数:400次  下载次数:51次

调整字体大小:

(此处下载失败可以在在线预览处保存副本或者右键另存为)

【摘要】:目的观察HBV相关慢加急性肝衰竭(HBV-ACLF)患者血清M30、CCL20的水平及其与短期(3个月)预后的关系,分析其临床意义。方法收集2014年10月-2017年1月在湖南省人民医院感染科诊治的HBV-ACLF患者51例(HBV-ACLF组);住院或门诊随访慢性乙型肝炎(CHB)患者30例(CHB组);健康体检者30例为对照组。HBV-ACLF患者随访3个月,根据随访结果分为存活组及死亡组。采用ELISA法检测各组基线及HBV-ACLF组患者治疗2周后外周血血清M30、CCL20水平。计量资料2组间比较采用t检验,多组间比较采用方差分析。结果治疗前HBV-ACLF组、CHB组和对照组M30、CCL20水平[(591.54±26206)、 (241.58±120.33)、 (114.35±52.09)U/L;(386.51±55.12)、 (177.11±27.51)、(33.95±11.62)pg/ml]3组间差异有统计学意义(F值分别为22.75、51.47,P值均<0.05)。治疗2周后HBV-ACLF死亡组患者M30水平显著高于存活组[(648.17±285.55) U/L vs (426.43±217.64)U/L,t=2.37,P<0.05],HBV-ACLF死亡组CCL20水平显著低于存活组[(232.28±39.28) pg/ml vs (352.29±52.43)pg/ml,t=-2.35,P<0.05]。治疗2周时与治疗前HBV-ACLF死亡组和存活组血清M30和CCL20水平的变化率[(0.08±0.04)vs(0.27±012);(0.39±0.06)vs(0.11±0.02)]差异均有统计学意义(t值分别为2.49、2.54,P值均<0.05)。结论血清M30、CCL20水平在 HBV-ACLF患者中显著升高,能够较为准确的反映肝脏的细胞凋亡及炎症程度。治疗过程中CCL20水平明显下降的患者病死率更高,M30水平明显下降的患者有相对较好的预后,动态观察M30、CCL20水平变化可能对预测HBV-ACLF患者的短期预后有一定价值。
【Abstract】:ObjectiveTo investigate the serum levels of M30 and CCL20 and their association with short-term (3-month) prognosis in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF), as well as their clinical significance. MethodsA total of 51 patients with HBV-ACLF who were diagnosed and treated in Hunan Provincial People′s Hospital from October 2014 to January 2017 were enrolled as HBV-ACLF group; 30 patients with chronic hepatitis B (CHB) who were hospitalized or followed up in the outpatient service were enrolled as CHB group; 30 healthy individuals who underwent physical examination were enrolled as control group. The patients with HBV-ACLF were followed up for 3 months, and according to the results of follow-up, these patients were divided into survival group and death group. ELISA was used to measure the serum levels of M30 and CCL20 in peripheral blood before treatment and after two weeks of treatment. The t-test was used for comparison of continuous data between two groups, and an analysis of variance was used for comparison between multiple groups. ResultsThere were significant differences in the serum levels of M30 and CCL20 before treatment between the HBV-ACLF group, the CHB group, and the control group (M30: 591.54±262.06 U/L vs 241.58±120.33 U/L vs 114.35±52.09 U/L, F=22.75,P<0.05; CCL20: 386.51±55.12 pg/ml vs 177.11±27.51 pg/ml vs 33.95±11.62 pg/ml, F=51.47,P<005). After two weeks of treatment, the HBV-ACLF death group had a significantly higher level of M30 than the HBV-ACLF survival group (648.17±285.55 U/L vs 426.43±217.64 U/L, t=2.37, P<0.05) and a significantly lower level of CCL20 than the HBV-ACLF survival group (232.28±3928 pg/ml vs 352.29±52.43 pg/ml, t=-2.35, P<0.05). After 2 weeks of treatment, there were significant differences in the change rates of the serum levels of M30 and CCL20 between the two groups (M30: 0.08±0.04 vs 0.27±0.12, t=2.49, P<0.05; CCL20: 0.39±0.06 vs 0.11±0.02, t=2.54, P<0.05). ConclusionPatients with HBV-ACLF have significant increases in the serum levels of M30 and CCL20, which can accurately reflect cell apoptosis and inflammation in the liver. Patients with a significant reduction in CCL20 during treatment tend to have high mortality, and patients with a significant reduction in M30 tend to have good prognosis. Dynamic changes in M30 and CCL20 levels have a certain value in predicting the short-term prognosis of patients with HBV-ACLF.
【关键字】:肝功能衰竭; 肝炎病毒, 乙型; 角蛋白18; 趋化因子CCL20
【Key words】:liver failure; hepatitis B virus; keratin-18; chemokine CCL20
【引证本文】:CHEN HO, LIU S, LIN YH. Expression of M30 and CCL20 in serum in patients with HBV-related acute-on-chronic liver failure and their clinical significance[J]. J Clin Hepatol, 2018, 34(4): 806-809. (in Chinese)
陈海鸥, 刘适, 林一鹤. HBV相关慢加急性肝衰竭患者血清M30和CCL20水平变化及意义[J]. 临床肝胆病杂志, 2018, 34(4): 806-809.

地址:长春市东民主大街519号《临床肝胆病杂志》编辑部 邮编:130061 电话:0431-88782542/3542
临床肝胆病杂志 版权所有 Copyright © 2009 - 2013 Lcgdbzz.org. All Rights Reserv 吉ICP备10000617号

吉公网安备 22010402000041号