慢性乙肝患者血清趋化因子RANTES水平与肝功能生化指标等的相关性研究

Correlation of serum chemokine RANTES level with serum biochemical indices, HBeAg and HBV DNA load in patients with chronic hepatitis B

目的了解慢性乙型肝炎（慢性乙肝）患者血清趋化因子RANTES水平，探讨血清RANTES水平与丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、总胆红素（TBil）、凝血酶原活动度（PTA）、乙型肝炎e抗原（HBeAg）及乙型肝炎病毒（HBVDNA）载量的相关性。方法选择144例慢性乙肝患者（观察组）和18名健康人（对照组），采取静脉血并应用ABC—ELISA方法检测其血清中趋化因子RANTES浓度，并与两组的肝功能检测生化指标、HBeAg和HBVDNA载量进行相关性分析，利用SPSS13．0软件进行统计分析。结果慢性乙肝患者血清RANTES的浓度比正常对照组升高，血清RANTES浓度分别为（3930．12±2856．96）ng／ml和（329．46±152．23）ng／ml，两组之间差异比较均有统计学意义（P〈0．05）；RANTES水平与ALT（r=0．197，P=0．018）、AST（r=0．239，P=0．004）和TBil（r=0．316，P=0．001）呈显著正相关；RANTES水平与PTA（r=-0．078，P=0．357）无显著相关；HBeAg阴性组与HBeAg阳性RANTES水平比较无统计学意义（P=0．407）；HBVDNA低载量组（〈10^5拷贝／ml）和HBVDNA高载量组（≥10^5拷贝／ml）RANTES水平比较无统计学意义（P=0．185）。结论慢性乙肝患者血清中RANTES表达水平增高，血清RANTES水平与ALT、AST和TBIL呈正相关，与PTA无相关性。RANTES水平可反映肝脏炎症活动及损害情况，不受HBeAg、HBVDNA载量影响，可能参与慢性乙肝发病。

Objective To investigate the level of the serum chemokine RANTES and its correlation with serum biochemical indices of liver function test, HBeAg and HBV DNA load in patients with chronic hepatitis B. Methods 144 patients with chronic hepatitis B （observed group） and 18 normal cases （control group） were enrolled in this study. The serum level of ehemokine RANTES was detected with an ABC-ELISA assay. Statistical analysis was performed on the software of SPSS13.0.Results The serum chemokine RANTES level in the observed group （3930.12 ng/ml ± 2856.96） ng/ml was significantly higher than that in the control group （329.46 ng/ml ± 152.23） ng/ml. The results from the observed group indicated the positive correlation of serum RANTES level with indices of liver function test, including ALT （ r = 0.197, P = 0.018）, AST（ r = 0.239, P = 0.004） and TBil （ r = 0.316, P = 0.001 ）, but did not with PTA （ r = - 0.078, P = 0.357）. Neither difference of serum chemokine RANTES level between HBeAg-positive group and HBeAg-negative group nor that between high HBV DNA load group （ ≥ 10^5 copies/ml） and low HBV DNA load group （ 〈 10^5 copies/ml） were statistically significant （ P = 0.407 and 0.185, respectively）. Conclusions Serum ehemokine RANTES level in patients with chronic hepatitis B elevates significantly and is not affected by HBeAg or HBV DNA load. Its positive correlation with indices of liver funetion test indicates that RANTES might play an important role in the pathogenesis of chronic hepatitis B.