丙型肝炎病人丙肝病毒RNA载量、肝脏纤维化与25羟基维生素D水平的相关性分析

Analysis the correlation between HCV RNA,liver fibrosis and 25 hydroxy vitamin D levels in Patients with hepatitis C

目的考察25羟基维生素D[25(OH)D]水平在丙型肝炎中的表达水平,分析25(OH)D与丙肝病毒RNA(HCV RNA)载量、肝脏纤维化之间的关联和影响关系。方法选取慢性丙型肝炎病人267例作为观察组,另选取正常体检者100例作为对照组,检测丙氨酸氨基转氨酶(ALT)、天冬氨酸氨基转移酶(AST)和谷氨酰转肽酶(GGT)。采用荧光定量PCR仪测定HCV RNA载量,采用肝脏纤维化指数(Fibrotest分级)进行评价肝纤维化程度。结果观察组ALT和AST、GGT显著高于对照组(P<0.01),观察组25(OH)D显著低于对照组(P<0.01);观察组>50~≤75 nmol·L^(-1)项下25(OH)D人数显著多于对照组(P<0.01);血清25(OH)D与HCV RNA载量呈负相关(r=-0.922,P<0.01),血清25(OH)D与Fibrotest分级呈负相关(r=-0.957,P<0.01)。结论 25(OH)D是丙肝的保护因素,临床对丙肝病人适当补充25(OH)D或可改善病人的临床症状。

Objective To investigate the expression level of 25 hydroxy vitamin D [25 （OH）D] in hepatitis C and analyze the correla-tion between 25 （ OH） D and HCV RNA, liver fibrosis. Methods 267 cases of chronic hepatitis C patients were selected as Hepatitis C group. Another 100 cases of normal physical examination in our hospital were selected as the control group. The alanine aminotrans-ferase （ALT） and aspartate aminotransferase （AST） and glutamyl transpeptidase （GGT） of patients were detected. The content of RNA HCV was measured by fluorescence quantitative PCR instrument, and the degree of liver fibrosis was evaluated by Fibrotest grading. Results ALT AST,GGT in hepatitis C group was significantly higher than the control group （P 〈0. 01） . 25（ OH） D in hepa-titis C group was significantly lower than the control group （P〈0. 01）.25（ OH） D number in hepatitis C group 〉 50 ？矣 75 nmol ？ L 1 was significantly higher than that in control group （P 〈 0. 01） . Serum 25 （ OH） D and HCV viral showed a negative correlation （r = - 0. 922 ,P 〈0. 01） ,and serum 25 （ OH） D and FibroTest grading showed a negative correlation （r = - 0. 951 ,P 〈0. 01） . Conclusions 25 （ OH） D is a protective factor for hepatitis C,which s can improve the clinical symptoms of patients of hepatitis C.