慢性乙型肝病患者肝组织和血清TGF-β1的测定及临床意义

Detection of hepatic and serum TGF-β1 levels in patients with HBV-induced chronic liver diseases and its clinical significances

目的探讨慢性乙型肝病(CLD-B)患者血清TGF-β1水平变化在反映肝脏炎症和纤维化程度的诊断意义。方法采用ELISA法检测155例CLD-B患者血清TGF-β1水平,对其中31例患者的肝穿活体组织进行原位杂交检测TGF-β1 mRNA,HE染色和Van Gieson氏胶原染色进行炎症分级和纤维化分期。结果慢性乙型肝炎(CHB)及活动性肝硬化患者血清TGF-β1水平显著高于对照组(P<0.01),TGF-β1水平在活动性肝硬化最高(P<0.05),而静止性肝硬化升高不明显(P>0.05)。CLD-B患者血清TGF-β1分泌水平与肝组织TGF-β1 mRNA表达强度展示良好的一致性。Spearman相关分析显示:CLD-B患者血清TGF-β1水平与肝组织炎症分级及早期肝纤维化分期呈正相关(r=0.721,r=0.683,均为P<0.05)。结论 CLD-B患者检测血清TGF-β1对推断肝脏炎症和早期肝纤维化的程度具有临床诊断意义。

Objective To investigate the relationship between the severity of liver histology and serum TGF-β1 level in patients with HBV-induced chronic liver diseases（CLD-B）.Methods ELISA was used to measure TGF-β1 in sera from 89 patients with chronic hepatitis B（CHB） and 66 patients with hepatitis B-induced liver cirrhosis and 30 healthy individuals.Liver samples from 26 patients with CHB and 5 patients with hepatitis B-induced liver cirrhosis were examined for TGF-β1 mRNA levels by in situ hybridization,and computer imaging analysis was performed to measure integrated optimal density（IOD） of TGF-β1 mRNA-positive cells in liver tissues.HE staining and Van Gieson＇s method were used to evaluate histological inflammation grading and fibrosis staging.Results The levels of TGF-β1 in sera from patients with CHB and active liver cirrhosis were significantly higher than those in healthy controls（P〈0.01）.There was good consistency between the levels of TGF-β1 in sera and TGF-β1 mRNA expression in liver tissues.The levels of TGF-β1 in sera were positively correlated with the degree of inflammation and the degree of earlier fibrosis stages in patients with CLD-B（r=0.721,r=0.683,both P〈0.05）.Conclusion Detection of serum TGF-β1 in patients with CLD-B may have clinical significance for the diagnosis of hepatic inflammation and early stage fibrosis.