慢性丙型肝炎肝组织学改变与肝脏瘦素表达的关系

The relationship between liver leptin expression and liver histological changes in patients with chronic hepatitis C

目的研究慢性丙型肝炎(CHC)肝组织学改变与肝脏瘦素表达的关系。方法未经治疗的53例成年CHC患者分为肝脏瘦素阳性组26例和阴性组27例,以单纯非酒精性脂肪性肝病(NAFLD)15例作为对照组,比较各组肝脏瘦素阳性率、肝脏炎症分级、纤维化分期和脂肪变分级有无差异。结果 CHC组脂肪变分级程度轻于NAFLD组(χ2=13.20,P<0.05),但两组分别在脂肪变1级和2级的肝脏瘦素阳性率差异无统计学意义(χ2=2.57,0.04,P均>0.05);两组在轻度炎症和轻度纤维化的瘦素表达阳性率差异有统计学意义,CHC组肝脏瘦素阳性率低于NAFLD组(χ2=4.54,6.86,P均<0.05)。两组CHC的肝脏瘦素阳性率在不同肝脏炎症分级、纤维化分期和是否发生肝脂肪变差异无统计学意义(χ2=0.106,0.846,0.000,P均>0.05),CHC的肝脏瘦素阳性率与肝脏炎症分级、纤维化分期、脂肪变分级和血清HCVRNA水平无明显相关性(P均>0.05)。结论 CHC发生肝脂肪变、肝脏炎症和纤维化程度均与肝脏瘦素表达无明显相关。

Objective To study the relationship between liver leptin expression and liver histological changes in patients with chronic hepatitis C （CHC）. Methods A total of 53 patients with untreated CHC were divided into liver leptin positive group （ n = 26 ） and negative group （ n = 27 ）, 15 non-alcoholic fatty liver disease （NAFLD） patients as eentrels. The liver leptin expression, liver inflammation grade, fibrosis stage and steatosis grade were detected. Results The degree of hepatic steatosis in CHC with fatty liver were significantly less than that in NAFLD（X^2 = 13.20,P 〈 0. 05 ）, while the positive rate of liver leptin in steatosis grade I and grade 2 were not significant different between CHC and NAFLD （ X^2 = 2. 57,0. 04, respectively, all P 〉 0. 05 ）. There were significant difference in the positive rate of liver leptin between CHC and NAFLD in mild inflammation grades or in mild fibrosis stages, which were lower in CHC than in NAFLD （X^2 = 4. 54,6. 86, respectively, all P 〈 0. 05 ）. There were no significant difference in the positive rate of liver leptin between two groups of CHC in different inflammation grades , fibrosis stages and the presence of hepatic steatosis （X^2 = 0. 106,0. 846,0. 000 ,respectively, all P 〉 0. 05 ）. No close relationship was found between the positive rate of liver leptin and the degree of liver inflammation ,fibrosis stage ,the dega^ee of hepatic steatosis and serum levels of HCVRNA in patients with CHC （ P 〉 0. 05 ）. Conclusions The expression of liver leptin is not related to the degree of liver inflammation , liver fibrosis and the presence of hepatic steatosis in patients of CHC.