乙型肝炎肝硬化患者血清促血小板生成素水平与不同HBV-DNA载量、Child-Pugh分级、血小板数之间的关系

Relationship between serum thrombopoietin level and HBV-DNA load,Child-Pugh grade and platelet count of Hepatitis B cirrhosis patients

目的检测乙型肝炎肝硬化患者促血小板生成素(TPO)水平,探讨肝硬化患者不同HBV-DNA载量、Child-Pugh分级、血小板数与血清TPO的关系。方法选取乙型肝炎肝硬化组患者26例,正常对照7例。根据HBV-DNA不同载量分为<103IU/ml、103~104IU/ml、105~106IU/ml组;根据Child-Pugh分级将乙型肝炎肝硬化分为Child-Pugh A级、Child-Pugh B级、Child-Pugh C级;根据血小板数分为<50×109/L、50×109/L^100×109/L、>100×109/L组。全自动血细胞检测仪测定血小板数,PCR-荧光探针法测定HBV-DNA,酶联免疫吸附试验(ELISA)检测血清TPO水平。结果 (1)乙型肝炎肝硬化HBV-DNA不同载量组TPO值均降低[(3.20±2.43)ng/ml、(2.90±2.52)ng/ml、(2.15±0.85)ng/ml],与正常对照组[(8.26±2.60)ng/ml]相比,差异均有统计学意义(F=12.092,P<0.05);HBV-DNA不同载量组间差异无统计学意义(t值分别为0.28、1.01、0.69,P>0.05)。(2)乙型肝炎肝硬化Child-Pugh A级、B级、C级血清TPO值均降低[(2.30±1.21)ng/ml、(3.28±2.79)ng/ml、(2.90±2.13)ng/ml],与正常对照组[(8.26±2.60)ng/ml]相比,差异均有统计学意义(F=12.103,P<0.05);不同Child-Pugh分级组间差异无统计学意义(t值分别为-1.02、-0.51、0.32,P>0.05)。(3)乙型肝炎肝硬化不同血小板数组血清TPO分别为[(3.26±2.03)ng/ml、(2.00±1.05)ng/ml、(3.21±2.57)ng/ml],与正常对照组[(8.26±2.60)ng/ml]相比,差异均有统计学意义(F=12.781,P<0.05);不同血小板数组间差异无统计学意义(t值分别为1.07、0.04、1.29,P>0.05)。结论乙型肝炎肝硬化患者血清TPO明显减低,可能与肝硬化肝功能改变、HBV-DNA病毒复制、血小板计数有关,但不同Child-Pugh分级、不同HBV-DNA病毒载量、不同血小板计数间血清TPO无明显变化,推测肝硬化患者血清TPO水平受肝硬化多种因素影响。

Objective To detect serum thrombopoietin （ TPO） level of Hepatitis B cirrhosis patients and to study the relationship between serum TPO level and HBV-DNA load, Child-Pugh grade and platelet count in Hepatitis B patients with liver cirrhosis .Methods Twenty-six Hepatitis B cirrhosis patients and 7 healthy volunteers were included in the study .Patients were divided into 〈10^3 IU/ml, 10^3-10^4 IU/ml,105-106 IU/ml according to different HBV-DNA load, cirrhosis Child-Pugh A grade, Child-Pugh B grade, Child-Pugh C grade according to the Child-Pugh classification, and〈50 ×10^9/L, 50 ×10^9-100 ×10^9/L, 〉100 × 10^9/L according to platelet count .Platelet count was detected by full automatic blood cell detector , HBV-DNA load by PCR-fluorescence method , serum TPO by enzyme-linked immunosorbent assay .Results （ 1 ） Compared with normal control group [（8.26 ±2.60） ng/ml], the serum TPO of different HBV-DNA load in Hepatitis B patients with liver cirrhosis decreased significantly [（3.20 ±2.43） ng/ml, （2.90 ±2.52） ng/ml, （2.15 ±0.85） ng/ml], and the differences were statistically significant （F =12.092,P〈0.05）.The differences among different HBV-DNA load groups were not statistically significant t=0.28,1.01,0.69,P〉0.05）.（2） The serum TPO of patients with different Child-Pugh classification [（2.30 ±1.21） ng/ml, （3.28 ±2.79） ng/ml, （2.90 ±2.13） ng/ml] decreased significantly compared with normal control group [（8.26 ±2.60） ng/ml] （F=12.103,P〈0.05）.The differences among different Child-Pugh classification groups were not statistically significant （t =-1.02, -0.51, 0.32,P〉0.05）.（3）The serum TPO of patients with different platelet count [（3.26 ±2.03） ng/ml, （2.00 ±1.05） ng/ml, （3.21 ±2.57） ng/ml] decreased significantly compared with normal control group [（8.26 ±2.60） ng/ml] （F=12.781,P〈0.05）.The differences among different platelet count groups were not statistically significant （ t=1.07, 0.04, 1.29, P〉00.5 ）.Conclusions The serum TPO in Hepatitis B patients with liver cirrhosis is very lower than the normal group .The differences of the serum TPO level among different HBV-DNA load groups, different Child-Pugh grade groups and different platelet count groups are not statistically significant .The serum TPO level may be affected by many factors .