慢性乙型肝炎患者血清25羟维生素D_3水平与肝功能及肝纤维化的关系

Relationship between serum levels of 25-hydroxyvitamin D_3 and liver function,liver fibrosis in patients with chronic hepatitis B

目的：探讨慢性乙型肝炎（CHB）患者血清25-羟维生素D3（25-（OH）D3）水平的变化及其与肝功能、肝纤维化的关系。方法：检测86例CHB患者（乙肝组）和30例健康献血者（对照组）的血清25-（OH）D3、CHB患者的肝功能指标谷丙转氨酶（ALT）、谷草转氨酶（AST）、总胆红素（TBIL）,肝纤维化标志物透明质酸（HA）、LN（层黏连蛋白）、Ⅲ型前胶原（PⅢ）、IV型胶原（CⅣ）,并且对患者的肝功能进行Child-Pugh分级（A、B、C级）,肝纤维化进行分期（S0~S4期）,并进行比较分析。结果：（1）乙肝组血清25-（OH）D3水平低于对照组,差异有统计学意义（P〈0.05）。（2）肝功能A、B、C级的血清25-（OH）D3水平依次降低,各级之间的差异有统计学意义（P〈0.05）。血清25-（OH）D3水平与肝功能分级呈负相关性（P〈0.05）,与AST、ALT、TBIL呈负相关性（P〈0.05）。（3）血清25-（OH）D3水平在肝纤维化S0~S4期水平依次降低,除S0与S1、S3与S4差异无统计学意义（P〉0.05）外,其他各期之间差异均有统计学意义（P〈0.05）,血清25-（OH）D3水平与肝纤维化分期有负相关性（P〈0.05）;血清25-（OH）D3与肝纤维化标志物HA、LN、PⅢ、CⅣ有负相关性（P〈0.05）。结论：乙肝患者血清25-（OH）D3水平降低与肝功能下降及肝纤维化加重有关。

Objective：To explore the relationship between serum levels of 25-hydroxyvitamin D3[25-（OH）D3]and liver function,liver fibrosis in patients with hepatitis B（CHB）.Methods：Serum levels of 25-（OH）D3,liver function alanine transaminase（ALT）,aspertate aminotransferase（AST）,total bilirubin（TBIL）,liver fibrosis indexs（hyaluronic acid（HA）,laminin（LN）,collagen protein Ⅲ（PCⅢ）,type Ⅳ collagen（CⅣ））in 86 patients with hepatitis B（hepatitis B group）and 30 healthy blood donors（healthy control group）were detected.Patients with hepatitis B were classified as A,B,C according to Child-Pugh classification and staging of the liver fibrosis（S0– S4）and comparative analysis was performed.Results：Serum levels of 25-（OH）D3in hepatitis B group was significantly lower than that in the control group（P 〈0.05）.Serum levels of 25-（OH）D3was reduced in turn in the liver function of Child A,B and C grade,with statistically significant difference（all P 〈0.05）.Serum levels of 25-（OH）D3was negatively correlated with the liver function classification,AST,ALT and TBIL（all P〈0.05）.The serum levels of 25-（OH）D3was significantly reduced in turn in the liver fibrosis S0-S4period（all P〈0.05）except S0 and S1,S3 and S4（P〉 0.05）.Serum levels of 25-（OH）D3had negative correlation with liver fibrosis stage,HA,LN,PⅢ and CⅣ（all P〈0.05）.Conclusions：The low serum levels of 25-（OH）D3is associated with liver function and liver fibrosis in patients with chronic hepatitis B.