肝硬化患者胃黏膜中生长激素释放肽的表达

Expression of ghrelin in gastic mucosa of patients with liver cirrhosis

目的探讨失代偿期肝硬化患者胃黏膜中生长激素释放肽(Ghrelin)的表达。方法随机选取2009年5月-2012年4月就诊于青岛市市立医院的乙肝后肝硬化患者47例、慢性乙型肝炎患者18例,同时选取胃镜检查大致正常的健康志愿者19例作为对照组,用免疫组化的方法检测胃黏膜中Ghrelin的表达。结果①肝硬化组患者与对照组相比,胃黏膜内Ghrelin的阳性表达率下降(P<0.05),幽门螺杆菌(Helicobacter pylori,H.pylori)感染率升高(P>0.05)。②慢性乙型肝炎组患者与对照组比较,胃黏膜内Ghrelin的阳性表达率下降(P<0.05),H.pylori感染率升高(P>0.05)。③肝硬化组与慢性乙型肝炎组相比,胃黏膜内Ghre-lin的阳性表达率下降(P>0.05),H.pylori感染率升高(P>0.05)。④肝功能Child-pugh分级与Ghrelin的阳性表达率无相关性(P>0.05);随着肝功能Child-pugh分级的增加,H.pylori的感染率呈上升趋势,但差异无统计学意义(P>0.05)。⑤对照组、慢性乙型肝炎组、肝硬化组、Child-pugh A级、Child-pugh B级、Child-pugh C级组内H.pylori阳性的患者胃黏膜中Ghrelin的阳性表达率与H.pylori阴性的相比升高,但各组内两者间的比较差异均无统计学意义(P>0.05)。结论乙肝后肝硬化患者胃黏膜损伤,导致胃黏膜内Ghrelin的表达减少,推测Ghrelin可能成为预测肝硬化患者胃黏膜病变的程度的指标。H.pylori感染加重胃黏膜的损伤,建议早期干预治疗肝硬化患者的H.pylori感染。Ghrelin可能具有抵抗H.pylori感染的作用。

Objective To investigate the expression of Ghrelin in gastric mucosa of patients with liver cirrhosis. Methods 47 patients with HBV cirrhosis and 18 chronic hepatitis B patients at our hospital from May 2009 to Apr. 2012 were enrolled in this study. 19 healthy volunteers were taken as control group. The expression of Ghrelin in gastric mucosa was determined by immunohistoehemistry staining. Results ① The expression of Ghrelin in gastric mucosa of patients with liver cirrhosis was lower than that in the control group （P 〈 0.05 ） , but the infection rate of Helieobacter pylori （H. pylori） of patients with liver cirrhosis was higher than that in the control group （P 〈 0.05 ）. ② The expression of Ghrelin in gastric mucosa of chronic HBV-infected patients was lower than that in the control group （ P 〈 0.05 ） , but the infection rate of H. pylori of chronic HBV-infected was higher than that in the control group （P 〈 0.05 ）. ③ The expression of Ghrelin in gastric mucosa of patients with liver cirrhosis was lower than that in the chronic HBV-infected group （P 〈 0.05） , but the infection rate of H. pylori of patients with liver cirrhosis was higher than that in the chronic HBV-infeeted group （P 〈 0.05 ）. ④ The expression of Ghrelin in gastric mucosa has no relationship with the Childpugh classification （P 〉0.05）. With Child-pugh classification higher, the infection rate of H. pylori became higher too （P 〉 0.05）. ⑤ In all the groups, the expression of Ghrelin in gastric mueosa of H. pylori positive patients was higher than that in the H. pylori negative patients （P 〈 0. 05）. Conclusion Because of the impairment of gastric mueosa, liver cirrhosis may reduce the expression of Ghrelin in gastric mucosa. Therefore, Ghrelin may be one of indexes which cloud forecast the conditions of gastric mucosa of patients with liver cirrhosis. H. pylori injures the gastric mucosa, so we should cure the infection of H. pylori in patients with HBV and liver cirrhosis early. Ghrelin may resist H. pylori imfection Hepatitis B