慢性乙型肝炎患者血清炎性反应指标与肝组织炎性反应分级及纤维化的关系

Relationship between serum inflammatory markers and inflammation grade and tissue fibrosis markers in CHB patients

目的探讨慢性乙型肝炎(CHB)患者血清炎性反应指标与肝组织炎性反应分级及纤维化的关系。方法选取2015年6月至2016年6月该院收治的120例CHB患者作为CHB组,另选取100例健康体检者作为健康对照组,测定两组研究对象血清总胆红素(TBiL)、丙氨酸氨基转移酶(ALT)、单核细胞趋化蛋白-1(MCP-1)、转化生长因子-β1(TGF-β1)、白细胞介素-6(IL-6)水平,并根据肝组织病理学诊断将CHB患者肝组织炎性反应分为G0~G4级,根据纤维化程度分为S0~S4期,分析CHB患者血清学指标与肝组织炎性反应分级及纤维化的关系。结果 CHB组血清TBiL、ALT、MCP-1、TGF-β1、IL-6水平均高于健康对照组,差异均有统计学意义(P<0.05)。CHB组肝组织炎性反应分级G0~G2级者血清TBiL、ALT、MCP-1、TGF-β1、IL-6水平均低于G3~G4级者,差异有统计学意义(P<0.05)。CHB纤维化分期S0期血清TBiL、ALT、MCP-1、TGF-β1、IL-6水平低于S1~S2期,S1~S2期各项指标均低于S3~S4期。经Spearman相关性分析显示,肝组织炎性反应分级与MCP-1、TGF-β1、IL-6呈正相关(P<0.05),纤维化分期与MCP-1、TGF-β1、IL-6呈正相关(P<0.05)。结论 CHB患者血清MCP-1、TGF-β1、IL-6水平与CHB肝组织炎性反应分级及纤维化有密切的关系,上述指标均可为CHB病情及预后判断提供参考。

Objective To investigate the relationship between serum inflammatory markers and liver inflammation grade and fibrosis in patients with chronic hepatitis B（CHB）.Methods A total of 120 cases of patients with CHB were enrolled in this study and 100 cases of healthy subjects were selected as controls groups from June 2015 to June 2016.The levels of serum total bilirubin（TBiL）,aspartate aminotransferase（ALT）,monocyte chemoattractant protein-1（MCP-1）,transforming growth factor-β1（TGF-β1）,interleukin-6（IL-6）in patients with CHB were measured by immunohistochemistry and histopathological examination.According to the pathological diagnosis of liver tissue,the activity of inflammatory response in patients with CHB was divided into G0-G4,according to the degree of fibrosis,CHB was divided into S0-S4,and the relationship between serum inflammatory markers and liver inflammation grade and fibrosis of liver tissue was analyzed.Results The levels of TBiL,ALT,MCP-1,TGF-β1and IL-6in CHB group were higher than those in control group（P〈0.05）.The levels of serum TBiL,ALT,MCP-1,TGF-β1and IL-6in G0-G2 group were lower than those in G3-G4group（P〈0.05）.The levels of serum TBiL,ALT,MCP-1,TGF-β1and IL-6in the S0 group were lower than those in the S1-S2 group,and thoses marks in the S1-S2 group were lower than those in the S3-S4group（P〈0.05）.The correlation analysis of Spearman showed that,liver tissue inflammation grade was positively correlated with MCP-1,TGF-β1and IL-6（P〈0.05）,the stage of fibrosis was positively correlated with MCP-1,TGF-β1and IL-6（P〈0.05）.Conclusion Serum levels of MCP-1,TGF-β1and IL-6in patients with CHB are closely related to inflammation grade and fibrosis of CHB.The above indexes can provide a reference for the diagnosis of CHB disease and prognosis.