慢性乙型肝炎患者血清瘦素水平的变化

Changes of serum leplin levels in patients with chronic hepatitis B

目的观察慢性乙型肝炎患者血清瘦素水平的变化。方法用ELISA法检测107例慢性乙型肝炎患者血清瘦素水平，用RIA法检测透明质酸（HA）、Ⅳ型胶原（cⅣ）、Ⅲ型前胶原（PCⅢ）、层黏蛋白（LN），测定其体重指数（BMI）；分析瘦素与肝功能、性别、体重指数和肝纤维化的关系。17例健康者作为对照组。结果对照组和慢性乙型轻度、中度、重度肝炎患者的血清瘦素水平分别为（2．00±2．57）μg／L、（4．64±4．38）μg／L、（6．30±5．96）μg／L、（7．79±6．66）μg／L，差异有统计学意义（F=5．00，P〈0．05）；女性患者的血清瘦素水平（10．30±6．47）μg／L显著高于男性患者的（4．44±4．52）μg／L（t=5．42，P〈0．01）；血清瘦素水平与肝纤维化程度呈正相关（r=0．277，P〈0．05）。结论慢性乙型肝炎患者的血清瘦素水平明显升高且存在性别差异，肝纤维化的程度与血清瘦素水平呈正相关。

Objective To investigate changes of serum leptin levels in patients with chronic hepatitis B, and to clarify its potential relations with liver function, gender, body mass index （BMI）, and the severity of liver fibrosis. Method 107 patients with chronic hepatitis B were included in this study and 17 healthy subjects enrolled at the same period served as controls. Serum leptin levels were determined by means of ELISA; serum markers of liver firosis, such as hyaluronic acid, collagen type Ⅳ, procollagen type Ⅲ and laminin, were determined by radioimmunoassay（RIA）. BMI was calculated by body height and weight. Results Serum leptin levels in patients with chronic hepatitis B increased significantly than those of controls （2.00±2.57μg/L）（F=5.00,P〈0.05）,andtheywere （4.64±4.38） μg/L, （6.30± 5.96） μg/L, （7.79 ±6.66） μg/L, in patients with chronic mild, moderate, sever hepatitis, respectively. Serum leptin levels of female patients were （ 10.30 ± 6.47） μg/L, significantly higher than those of males [ （4.44 ± 4.52） μg/L] （ t = 5.42, P 〈 0.01 ）. Serum leptin levels were positively related with the severity of liver fibrosis （ r = 0. 277, P 〈 0. 05）. Conclusions In chronic hepatitis B, serum leptin levels are significantly increased with gender differences. Serum leptin levels increase along with progress of liver fibrosis and are positively related with the severity of liver fibrosis, these show that lepfin plays a role in the process of liver fibrogenesis of chronic hepatitis B.