慢性乙型肝炎患者肝组织中维生素D受体表达与肝损伤的相关性

Correlation between the expression of vitamin D receptor and liver injury in patients with chronic hepatitis B

目的:研究慢性乙型肝炎患者肝组织维生素D受体(VDR)的表达及其下调机制。方法:选取60例慢性乙型肝炎患者作为研究组,按肝组织学结果分成3组,每组均20例。F1组:肝纤维化分级为1级;F2组:肝纤维化分级为2级;F3组:肝纤维化分级为3级。对照组选取20例因其他疾病行肝脏手术切除的标本。所有病例均检测HBVDNA和生化学指标,免疫组化染色检测VDR、CYP2R1、CYP27A1的表达。结果:对照组与慢性乙肝组比较,VDR在胆管上皮细胞的表达差异无统计学意义(P>0.05)。VDR、CYP2R1和CYP27A1在肝细胞的表达慢性乙肝组比对照组显著减弱(P<0.05)。在慢性乙肝组CYP2R1和CYP27A1相比VDR的表达显著减弱(P<0.05)。在F1、F2、F3组间3种受体的表达无统计学差异(P>0.05)。在慢性乙肝组VDR的表达与CYP2R1的表达呈显著正相关(P<0.05),与HBVDNA水平呈负相关(P<0.05)。结论:VDR在慢性乙肝患者肝细胞的表达与对照组相比显著下降,表达强弱与CYP2R1呈明显的正相关,与HBVDNA呈负相关。

Objective：To evaluate the hepatic expression of vitamin D receptor（VDR）,CYP2Rl,and CYP27A1 in patients with chronic hepatitis B （CHB）and their relationship with histological features of the hepatopathy. Methods：A total of 60 patients with CHB including 20 eases of liver fibrosis stage 1 （F1）,20 eases of liver fibrosis stage 2（F2）,and 20 eases of liver fibrosis stage 3（F3）were enrolled in the study.Twenty subjects with no history of liver disease served as the controls.All cases detected HBV DNA and biochemical parameters. Expression of VDR,CYP2R1 and CYP27A1 were evaluated by immunohistochemistry in hepatocytes and cholangiocytes.Results：VDR expression on cholangiocytes had no significant difference between in the control group and CHB group （P〉0.05）.VDR expression on hepatocytes of CHB group were weaker than that in the control group （P〈0.O5）.In CHB patients,expression of CYP27A1 and CYP2R1 appeared lower than VDR （P〈 O.05）.In addition,CYP27A1 and CYP2R1 expression appeared lower in CHB in comparison with controls （P〈 0.05）.The expressions of VDR,CYP2R1 and CYP27A1 had no significant differences among the three groups （F1 ,F2,F3）（P〉0.05）.In CHB patients,VDR expression on hepatocytes was strongly positively correlated with the hepatic reactivity for CYP2RI（P〈0.05）.And it was negatively correlated with HBV DNA（P〈0.05）.Conelnsion：VDR expression on hepatocytes of CHB decreased significantly in comparison with that in controls.In CHB patients,expression of CYP2RI,but not CYP27A1 has a positively correlation with VDR expression.In contrast,HBV DNA has a negatively correlated with VDR expression.