慢性乙型肝炎合并酒精性肝病患者血清瘦素测定的临床价值

Clinical value of the measuring the level of serum leptin in patients with chronic hepatitis B incorporate alcoholic liver disease

目的测定慢性乙型肝炎合并酒精性肝病患者血清瘦素水平，并探讨与胰岛素抵抗的关系。方法选择慢性乙型肝炎合并酒精性肝病患者17例，肝硬化15例，慢性乙型肝炎19例与12例男性健康受试者为对照组，各组间在性别、年龄和体质量指数（BMI）均相匹配。采用酶联免疫吸附法（ELISA）测定血清瘦素，同时测定血糖、血脂、胰岛素和肝肾功能等指标，并测量身高、体质量，计算BMI。并进行结果分析。结果慢性乙型肝炎合并酒精性肝病、肝硬化组血清瘦素水平高于对照组（P〈0．05），慢性乙型肝炎组与对照组比较差异无统计学意义（P〉0．05），慢性乙型肝炎合并酒精性肝病组瘦素水平与BMI、FINS呈显著正相关（r值分别为0．169，0．267，P〈0．05）；瘦素与三酰甘油里明显负相关（r值为-0．249，P〈0．05）。结论慢性乙型肝炎合并酒精性肝病患者血清瘦素水平明显增高，与高胰岛素血症和胰岛素抵抗存在相关性，瘦素表达不能评价肝病严重程度。

Objective To determine serum leptin levels in chronie hepatitis B ineorporate aleoholie liver disease （CHB＋ALD）, and investigate its relationship between insulin resistance in CHB＋ALD patients. Methods 17 male patients with CHB ＋ ALD,15 male patients with cirrhosis of liver,19 male patients chronic hepatitis B,and 12 male healthy control were enrolled in this study,matched for gender,age and body mass index （BMI）. The level of leptin was measured by ELISA. Fasting glucose, blood lipid, insulin levels, liver function and renal function were determined. Height, weight and BMI were also measured. Results Serum leptin levels in CHB＋ALD and cirrhosis of liver were significantly higher than those of healthy control（P〈0.05）. There was no significant difference of the chronic hepatitis B patients（P〉0.05）. Serum leptin levels in CHB＋ALD were significantly correlated with BMI, insulin, respectively（r=0.169,0.267 ,P〈0.05）. There were significant negative correlations both between serum leptin and triglycerides （TG） （r= -0.249, P〈0.05）. Conclusion Serum leptin levels height markedly in CHB＋ ALD,and relationship with higher insulin levels and in- sulin resistance. The expression of leptin is not relative to the severity in chronic hepatitis.