慢性乙型肝炎肝组织糜酶活性与肝纤维化相关性研究

Correlation between chymase activity and liver fibrosis in liver tissues of patients with chronic hepatitis B.

目的探讨慢性乙型肝炎患者肝组织糜酶活性与肝纤维化相关性。方法收集2009年1月至2012年3月延边大学附属医院消化科住院的慢性乙型肝炎患者46例,按肝脏病理肝纤维分级(S1～S4)进行分组,S1组10例,S2组15例,S3组15例,S4组6例;采用酶联免疫吸附试验(ELISA)检测肝组织中糜酶活性,采用胃酶酸解法测定肝组织胶原纤维及羟脯氨酸(HYP)含量,经Masson染色后直接测量胶原纤维面积与视野总面积比值,以该比值作为胶原纤维的相对含量。观察比较各组肝组织糜酶活性、胶原纤维含量和HYP含量。结果 S3组和S4组肝组织糜酶活性、肝脏胶原纤维含量及HYP含量均较S1组、S2组明显升高,差异有统计学意义(P<0.01),且纤维化程度重组(S3+S4)肝组织糜酶活性、胶原纤维含量及HYP含量明显高于纤维化轻组(S1+S2)(P<0.01);肝组织糜酶活性与肝组织胶原氨酸含量和HYP含量呈正相关,相关系数分别为0.685(P<0.05)和0.702(P<0.01)。结论慢性乙型肝炎患者肝组织中糜酶活性与肝组织胶原纤维含量和HYP含量呈正相关,可作为肝纤维化的评价指标之一。

Objective To study the correlation between chymase activity and liver fibrosis in liver tissues of patients with chronic hepatitis B.Methods Forty-six chronic hepatitis B cases hospitalized in our department from Jan.,2009 to March,2012 were divided into 4 groups(S1-S4).The chymase levels were determined by using the method of enzyme linked immunosorbant assay(ELISA).The contents of collagen fibrosis and HYP were detected by using the gastric enzyme method.The Masson staining was applied to measure field area and the total area of collagen fibers and their ratio.This ratio was considered as the relative amounts of collagen fibers.Chymase activity,contents of HYP and contents of collagen fibrosis were observed and compared.Results The levels of hepatic chymase,collagen fibrosis and HYP were significantly higher in S3 and S4 than in S1 and S2(P < 0.01).In addition,the levels of hepatic chymase,collagen fibrosis and HYP were higher advanced fibrosis groups(S3 + S4) than those in the mild fibrosis groups(S1 + S2)(P < 0.01).There was positive correlation between hepatic chymase levels and the levels of collagen fibrosis(r = 0.685,P < 0.05) or hydroxyproline(r =0.702,P < 0.01).Conclusion Chymase levels were positively correlated with those of the collagen fibrosis and HYP,and thus can be considered as an index for hepatic fibrosis in chronic hepatitis.