肝组织及血清中的AngⅡ、TGF-β1在慢乙肝肝纤维化中的作用研究

Study on the effect of Ang Ⅱ and TGF-β1 in liver tissue and serum on chronic hepatitis B liver fibrosis

目的探讨肝组织及血清中AngⅡ、TGF-β1的表达与不同程度慢乙肝患者肝纤维化的关系。方法选取2015年1月~2016年12月在本院住院的丙氨酸氨基转移酶(ALT)1~2倍升高的慢性HBV感染患者50例,均行肝穿刺活检术。根据Metavir评分系统进行组织学活动度(histologic activity,A)和纤维化分期(fibrosis,F)评分,将其分为轻度纤维化组(<A2F2)及显著纤维化组(≥A2F2),用ELISA法测定血清中AngⅡ、TGF-β1的水平,用免疫组化法测定肝组织的AngⅡ、TGF-β1水平。行肝功能、HBV DNA定量和肝纤维化指标检查。并对上述检查结果进行分析,初步了解血清AngⅡ、TGF-β1在轻度慢乙肝患者肝纤维化情况评估中的意义。结果严重纤维化程度高的慢乙肝患者,其血清及肝脏AngⅡ和TGF-β1水平也相应明显升高。结论 AngⅡ和TGF-β1在乙肝患者体内可能参与了肝纤维化进程,可作为乙肝患者肝纤维化程度的判定指标,为后续抗纤维化治疗提供新的思路。

Objective To investigate the expression of AngⅡ and TGF-β1 in liver tissue and serum and its relationship with chronic hepatitis B hepatic fibrosis with different degrees. Methods 50 patients with chronic HBV hospitalized in our hospital whose ALT was increased by 1-2 times from January 2016 to December 2016 were selected. Liver biopsy was performed in all patients. According to the Metavir scoring system, scores of histologic activity（A） and fibrosis staging （F） were calculated, and the patients were divided into mild fibrosis group（〈A2F2） and significant fibrosis group （≥ A2F2）. The levels of AngⅡ and TGF-β1 in serum were measured by ELISA, and the levels of AngⅡ and TGF-β1 in liver tissue were measured by immunohistochemistry. Liver function, HBV DNA quantitation, and liver fibrosis markers were tested, and the results of the above tests were analyzed. The significance of serum AAngⅡ and TGF-β1 in the assessment of hepatic fibrosis in patients with mild chronic hepatitis B was preliminarily investigated. Results The levels of AngⅡ and TGF-β1 in serum and liver were also significantly increased in patients with chronic hepatitis B with high degree of inflammation and fibrosis. Conclusion AngⅡ and TGF-β1 may be involved in the process of hepatic fibrosis in patients with hepatitis B, which can be used as the determination indicators for the degree of liver fibrosis in the patients with hepatitis B, and provide a new way of thinking for the subsequent anti-fibrosis treatment.