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Mindin蛋白在经聚乙二醇干扰素α-2b治疗的慢性乙型肝炎中的动态变化及意义

王怡恺 吴凤萍 刘晨瑞 郝苗 吕莎莎 张苗苗 党双锁 张欣

引用本文:
Citation:

Mindin蛋白在经聚乙二醇干扰素α-2b治疗的慢性乙型肝炎中的动态变化及意义

DOI: 10.12449/JCH240110
基金项目: 

陕西省自然科学基金 (2022JCYB-770)

伦理学声明:本研究方案由西安交通大学第二附属医院伦理委员会审批,批号为2018033。所有研究对象入组前均签署了书面知情同意书。
利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:王怡恺、张欣负责课题设计,资料汇总分析,撰写论文;吴凤萍、刘晨瑞、郝苗参与收集数据,修改论文;吕莎莎、张苗苗负责数据分析和整理;党双锁、张欣负责拟定写作思路,指导撰写文章并最后定稿。
详细信息
    通信作者:

    张欣, zn661@163.com (ORCID: 0000-0002-5966-0471)

Dynamic change and significance of Mindin protein in chronic hepatitis B treated with PEG-IFNα-2b

Research funding: 

Natural Science Foundation of Shaanxi Province (2022JCYB-770)

More Information
    Corresponding author: ZHANG Xin, zn661@163.com (ORCID: 0000-0002-5966-0471)
  • 摘要:   目的  分析聚乙二醇干扰素α-2b(PEG-IFNα-2b)治疗慢性乙型肝炎(CHB)过程中Mindin蛋白的变化以及作用。  方法  选取2018年1月—2019年12月于西安交通大学第二附属医院行PEG-IFNα-2b治疗的CHB患者29例,按照临床结局分为治愈组(n=17)与未治愈组(n=12)。分别采集治愈组和未治愈组基线、12周和24周的外周血样本,测量血常规、肝功能、乙型肝炎标志物定量和Mindin蛋白含量。分析比较各时间点HBsAg、ALT、AST及Minidn蛋白水平的组间差异。符合正态分布的计量资料两组间比较采用成组t检验;非正态分布的计量资料两组间比较采用Mann-Whitney U检验。采用Spearman相关性分析法对Mindin蛋白与HBsAg、ALT、AST的相关性进行分析。多元线性回归分析探讨HBsAg、ALT水平对Mindin蛋白的影响。  结果  基线资料分析发现,未治愈组和治愈组HBsAg、抗-HBe、Alb和白/球比值(A/G)水平两组间比较差异均有统计学意义(P值均<0.05)。治愈组Mindin蛋白水平呈现持续上升的趋势,24周时Mindin蛋白水平显著高于基线(P<0.05)。24周时治愈组Mindin蛋白水平显著高于未治愈组(P=0.019)。治愈组HBsAg水平均显著低于未治愈组,且组内各时间点与基线比较差异均具有统计学意义(P值均<0.05)。此外,治愈组ALT和AST的变化均呈现先升高后降低的趋势,12周的表达水平均显著高于基线(P值均<0.05)。未治愈组24周ALT和AST水平均显著高治愈组(P值均<0.05)。未治愈组12周时Mindin蛋白水平与ALT呈现出较强的直线相关性(r=0.760 8,P<0.05),进一步的多元线性回归分析同样证明两者间存在线性关系(偏回归系数为1.571,P=0.019)。  结论  PEG-IFNα-2b抗病毒治疗24周时的Mindin蛋白水平在治愈组和未治愈组间存在明显差异。提示通过检测Mindin蛋白的动态变化可以更好地预测慢性乙型肝炎的治疗结局,为临床提供参考。

     

  • 图  1  三组间基线Mindin水平比较

    Figure  1.  Comparison of baseline Mindin levels among cured, uncured, and healthy controls

    图  2  HBsAg、转氨酶和Mindin的动态变化

    Figure  2.  Dynamic changes in HBsAg, transaminase, and Mindin

    表  1  患者基线和人口统计学资料

    Table  1.   Baseline and demographic data of the patients

    基线特征 未治愈组(n=17) 治愈组(n=12) 统计值 P
    男性 60% 40% χ 2=4.441 0.060
    年龄(岁) 41.1±9.9 35.2±9.4 t=1.632 0.114
    HBsAg(log10IU/mL) 2.6±0.7 1.9±1.1 t=-1.996 0.046
    抗-HBs(mIU/mL) 0.3(0.0~2.2) 0.1(0.0~1.8) Z=-0.142 0.887
    HBeAg(s/co) 0.4(0.3~0.7) 0.4(0.3~0.6) Z=-0.349 0.727
    抗-HBe(s/co) 0.28(0.03~1.05) 0.01(0.01~1.10) Z=-2.108 0.035
    抗-HBc(s/co) 8.25±0.54 8.04±1.75 t=-0.279 0.781
    TBil(μmol/L) 11.9±4.5 14.2±6.6 t=-1.043 0.307
    DBil(μmol/L) 2.7(2.2~4.3) 3.3(2.0~4.7) Z=-0.171 0.864
    ALT(U/L) 25.3±16.3 19.8±12.0 t=-1.209 0.227
    AST(U/L) 25.1±10.1 20.4±5.1 t=-1.285 0.199
    总蛋白(g/L) 71.5±6.7 69.5±5.9 t=0.798 0.432
    Alb(g/L) 45.9±3.5 41.7±4.0 t=-2.135 0.033
    Glo(g/L) 25.6±4.1 27.9±3.7 t=-1.493 0.149
    白蛋白/球蛋白比值 1.8±0.3 1.5±0.2 t=-2.572 0.010
    GGT(U/L) 15.5(12.5~22.8) 17.0(11.0~38.8) Z=-0.258 0.797
    ALP(U/L) 74.5±24.8 63.1±34.0 t=-0.875 0.382
    总胆汁酸(μmol/L) 6.2(2.8~9.2) 3.2(1.8~7.2) Z=-0.978 0.328
    a-L-岩藻糖苷酶(U/L) 26.0±5.1 26.5±7.9 t=-0.542 0.588
    前白蛋白(mg/L) 225.8±31.9 212.1±46.3 t=0.863 0.397
    胆碱酯酶(U/L) 8 097.8±1 593.0 7 247.1±1 738.3 t=-1.543 0.131
    下载: 导出CSV

    表  2  HBsAg、转氨酶和Mindin基线、12周和24周的动态变化

    Table  2.   Dynamic changes in HBsAg, transaminase, and Mindin at baseline, 12 weeks, and 24 weeks

    指标 未治愈组(n=17) 治愈组(n=12) 统计值 P
    HBsAg(log10 IU/mL)
    基线 2.6±0.7 1.9±1.1 t=-1.996 0.046
    12周 2.7(1.9~3.1) 0.6(0.3~1.5) Z=-3.504 <0.001
    24周 1.7(1.1~2.7) 0.3(0.0~1.3) Z=5.436 <0.001
    ALT(U/L)
    基线 25.3±16.3 19.8±12.0 t=-1.209 0.227
    12周 27.0(18.0~57.0) 40.0(19.0~106.0) Z=-1.059 0.289
    24周 58.8±35.4 30.8±18.3 t=2.702 0.012
    AST(U/L)
    基线 25.1±10.1 20.4±5.1 t=-1.285 0.199
    12周 55.0(41.0~60.0) 68.0(46.0~111.0) Z=-1.082 0.279
    24周 60.9±25.6 37.1±15.4 t=3.018 0.006
    Mindin蛋白(pg/mL)
    基线 222.4±66.5 223.7±68.8 t=-0.051 0.959
    12周 260.1±65.0 259.5±71.9 t=0.024 0.981
    24周 251.5±38.4 317.3±51.2 t=-2.673 0.019
    下载: 导出CSV

    表  3  多元线性回归分析

    Table  3.   Multiple linear regression analysis

    指标 偏回归系数 95%CI P
    常量 154.681 52.698~256.664 0.009
    HBsAg 24.129 -17.199~65.456 0.210
    ALT 1.571 0.354~2.788 0.019
    AST -0.263 -1.230~0.704 0.540
    下载: 导出CSV
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