HBV相关慢加急性肝衰竭患者血清M30和CCL20水平变化及意义

陈海鸥; 刘适; 林一鹤

doi:10.3969/j.issn.1001-5256.2018.04.022

HBV相关慢加急性肝衰竭患者血清M30和CCL20水平变化及意义

DOI: 10.3969/j.issn.1001-5256.2018.04.022

1. 湖南省人民医院湖南师范大学附属第一医院感染科
2. 湖南省人民医院湖南师范大学附属第一医院检验科

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中图分类号: R512.62;R575.3
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出版历程
- 出版日期: 2018-04-20

Expression of M30 and CCL20 in serum in patients with HBV-related acute-on-chronic liver failure and their clinical significance

Department of Infectious Diseases, Hunan Provincial People′s Hospital & The First Affiliated Hospital of Hunan Normal University

摘要

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...
- 肝功能衰竭 /
- 肝炎病毒,乙型 /
- 角蛋白18 /
- 趋化因子CCL20
Abstract:
Objective To 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.Methods A total of 51 patients with HBV-ACLF who were diagnosed and treated in Hunan Provincial People's Hospital from October 2014 to January2017 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.Results There 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) .Conclusion Patients 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.
- liver failure /
- hepatitis B virus /
- keratin-18 /
- chemokine CCL20

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参考文献(13)

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