乙肝患者不同病理阶段铁调素与透明质酸的变化及临床意义

Changes of hepcidin and hyaluronic acid in patients with different stages of hepatitis B and their clinical significance

目的探讨乙肝患者不同病理阶段(肝炎、肝硬化、肝癌)血清中铁调素(Hepcidin)与透明质酸的变化及其临床意义。方法选择2013年1~12月于中南大学湘雅医学院附属海口医院消化内科收治的乙型肝炎病毒携带均大于10年的肝病患者61例作为病例组,其中慢性乙型肝炎患者作为病例A组共26例,肝硬化患者作为病例B组共20例,肝癌患者作为病例C组共15例,选取健康体检者作为对照组共35例,分别测定其铁调素与透明质酸。比较病例组与对照组铁调素与透明质酸的差异,并分别分析病例A、B、C组之间及其与对照组铁调素与透明质酸的差异。结果病例组患者的铁调素含量为(1 472.52±1 080.77)ng/m L,明显高于对照组的(316.03±134.58)ng/m L;透明质酸含量为(179.28±96.80)ng/m L,明显高于对照组的(83.65±13.28)ng/m L,差异均有显著统计学意义(P<0.01)。病例A、B、C组患者的铁调素均较对照组增高(P<0.05),但三个组之间比较差异均无统计学意义(P>0.05);病例B、C组透明质酸较对照组增高,较病例A组亦增高,差异均有统计学意义(P<0.05)。结论铁调素在肝病的不同病理阶段均增高,反映了肝病患者铁代谢失衡;透明质酸在肝硬化、肝癌中出现不同程度的增高,可作为肝纤维化的指标。

Objective To investigate the changes and clinical significance of hepcidin and hyaluronic acid by patients with different stages of hepatitis B（hepatitis, liver cirrhosis and liver cancer）. Methods From January 2013 to December 2013, 61 patients with liver disease（carrying hepatitis B virus for more than 10 years） were admitted to our hospital, which were divided into three groups, group A（n=26）, group B（n=20） and group C（n=15）. The control group（n=35） were selected from physical examination persons. Hepcidin and hyaluronic acid were measured and compared in the four groups. Results The content of hepcidin and hyaluronic acid in patients were（1 472.52±1 080.77） ng/m L and（179.28 ± 96.80） ng/m L, respectively, which were significantly higher than corresponding（316.03 ± 134.58） ng/m L and（83.65±13.28） ng/m L in the control group（P〈0.01）. The content of hepcidin in the three groups（hepatitis, liver cirrhosis, liver cancer） was significantly higher than that in the control group, but there was no significant difference between the three groups（P〉0.05）. The content of hyaluronic acid in group B and group C was significantly higher than that in group A and the control group（P〉0.05）. Conclusion Hepcidin are increased at different stages of liver disease, reflecting the iron metabolism imbalance in patients with liver disease. Hyaluronic acid is increased in in different degrees in liver cirrhosis and liver cancer, which can be used as an indicator of liver fibrosis.