血清超敏C反应蛋白在慢性乙型肝炎进展中的意义

Clinical significance of high-sensitivity C-reactive protein in development of chronic hepatitis

目的探讨血清超敏c反应蛋白（hs-CRP）在慢性乙型肝炎（CHB）进展中的意义。方法总共182例未经治疗的CHB患者和50名健康对照被纳入研究。对所有患者的血清hs-CRP水平与患者的年龄、性别、病史、血清HBVDNA水平、肝功能、肝脏硬度检测值（LsM）和肝组织纤维化分期进行了相关性分析。计量资料以均数±标准差G士s）表示，正态分布的均数比较用t检验，非正态分布的均数比较用秩和检验；相关性检验采用Pearson相关分析，等级相关性采用Spearman分析。结果CHB患者血清hs-CRP水平[（2．38±2．79）mg／L]显著高于健康对照[（0．78±1．07）mg／hl，t=2．495，P〈0．05。血清hs-CRP水平与患者年龄、性别和病程无明显相关眭泸〉0．05），与HBVDNA水平、总胆红素、ALT、AST和LSM呈正相关（r值分别为0．159，0．271，0．298，0．389，0．562，P值均〈0．05）；血清CRP水平与肝功能损害程度、LSM和肝组织纤维化分期呈正相关（r值分别为0．340，0．292，0．434，P值均〈0．01）。结论血清hs-CRP与CHB病毒的复制、肝功能损害程度及肝纤维化进展密切相关，但受肝功能损害程度的影响较大，其能否作为肝纤维化分期的指标尚需深入研究。

Objective To explore the clinical significance of high-sensitivity C-reactive protein （hs- CRP） in the development of chronic hepatitis B （CI-IB）. Methods A total of 182 patients with untreated CHB and 50 healthy individuals （controls） participated in the study. Correlation analysis was performed to determine the association of serum hs-CRP with the age, sex, medical history, serum hepatitis B virus （HBV） DNA, liver function parameters, liver stiffness measure （LSM） and hepatic fibrosis; in addition, correlation analysis was carried out for the associations of degree of liver damage with grade of hepatic fibrosis, LSM and the serum levels ofhs-CRP. Results CHB patients showed significantly higher serum hs-CRP levels than healthy controls （2.38±2.79 vs. 0.78±1.07; t = 2.495, P 〈 0.05）. Serum hs-CRP levels were significantly correlated with HBV DNA （r = 0.159）, liver function parameters （total bilirubin, r = 0.271; alanine aminotransferase, r = 0.298; aspartate aminotransferase, r = 0.389）, and LSM, r = 0.562） （all P 〈 0.05）. The correlations with liver function （r = 0.340）, LSM （r = 0.292） and hepatic fibrosis grade were positive （r = 0.434） （allP 〈 0.01）. Conclusion Serum hs-CRP levels in CHB patients can reflect degree of liver damage and of liver fibrosis.