乙型肝炎后肝硬化患者血清瘦素水平测定及其临床意义

Serum Leptin Level in Patients with Post-hepatitis B Cirrhosis and its Clinical Significance

背景:瘦素水平与肝脏疾病关系密切,但因研究对象及其病因、病情不同,各研究所得结论并不一致。目的:测定乙型肝炎后肝硬化患者的血清瘦素水平,探讨其与患者肝功能、性别、体重指数(BMI)和血清肝纤维化标志物水平的可能关系。方法:69例乙型肝炎后肝硬化患者根据Child-Pugh分级分为3组,以酶联免疫吸附测定检测血清瘦素、层黏连蛋白(LN)、Ⅲ型前胶原(PC-Ⅲ)和Ⅳ型胶原(CⅣ)水平;同时测量身高、体重,计算BMI。25名健康人作为对照组。结果:乙型肝炎后肝硬化患者的血清瘦素水平(18.64ng/ml±26.56ng/ml)显著高于健康对照组(12.04ng/ml±11.17ng/ml,P=0.043),但各Child-Pugh分级患者间差异无统计学意义。女性患者的血清瘦素水平显著高于男性(P=0.01)。血清瘦素水平还与BMI呈正相关(r=0.35,P=0.003),在超重者中,相关性尤为明显(r=0.537,P=0.002)。结论:乙型肝炎后肝硬化患者的血清瘦素水平明显升高且存在性别差异,该指标能反映患者体内的脂质代谢情况,但与病情无关。

Background： Leptin level is closely correlated with liver diseases. However, the conclusion varies because of different etiologies and state of illness. Aims： To investigate the serum leptin level in patients with post-hepatitis B cirrhosis and to clarify its potential relationships with liver function, gender, body mass index （BMI）, and the levels of serum fibrotic markers. Methods： Sixty-nine patients with post-hepatitis B cirrhosis were divided into three groups according to Child-Pugh classification. Serum levels of leptin, laminin, procollagen Ⅲ and collagen Ⅳ were determined by enzyme-linked immunosorbent assay （ELISA）. BMI was calculated by body height and weight. Twenty-five healthy subjects enrolled at the same period served as controls. Results： The serum leptin level of post-hepatitis B cirrhotic patients was significantly higher than that of the healthy controls （18.64 ng/ml±26.56 ng/ml vs. 12.04 ng/ml±11.17 ng/ml, P=-0.043）, but no statistical difference was found in serum leptin levels among the patients in various Child-Pugh stages. The serum leptin level of female patients was significantly higher than that of the males （P=0.01）. Positive correlation was observed between serum leptin level and BMI （r=0.35, P=0.003）, especially in overweight subgroup （r=0.537, P=0.002）. Conclusions： Serum leptin levels in post-hepatitis B cirrhotic patients are significantly increased with gender differences. It can reflect patients＇ lipid metabolism, but is not correlated with the severity of liver dysfunction.