慢性乙型肝炎患者血清sCD40表达水平与生化指标相关性

Correlation of serum sCD40 expression level and biochemical indexes in patients with chronic hepatitis B

目的探讨慢性乙型肝炎合并相关疾病患者血清中sCD40的表达情况以及临床上生化指标的相关性。方法选取2012年1月到2016年12月在本院肝病科接受治疗的慢性乙型肝炎住院患者150例为肝病组,并选取90例健康人作为对照,对患者血清中sCD40的表达以及与临床生化指标的相关性进行系统分析。结果肝病组患者和对照组血清sCD40浓度及25%~75%百分位数对比差异有统计学意义(P<0.05);慢性肝炎组中血清sCD40水平与丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)水平呈正相关关系(r=0.57、0.36,P<0.05);肝硬化患者组的血清sCD40的水平与碱性磷酸酶(ALP)呈正相关关系(r=0.78,P<0.05);重型肝炎患者死亡患者血清中sCD40水平(231.52±101.98)pg/m L远高于存活患者(t=2.14,P=0.02);入院之初并发性肝脏疾病患者血清中sCD40水平(236.56±117.45)pg/m L与未有并发性肝脏疾病患者血清中sCD40水平(120.35±82.41)pg/m L相比,差异有统计学意义(P<0.05)。结论在慢性乙型肝炎患者血清中,sCD40呈现出异常高表达状态,sCD40可作为评价肝脏细胞损伤程度的免疫学指标对肝衰竭预后状况进行评估。

Objective To study the expression level of sCD40 in serum of patients with chronic hepatitis B complicated with related diseases and the correlation of clinical biochemical indexes. Methods 150 cases of patients with chronic hepatitis B treated in our hospital hepatology department from January 2012 to December 2016 were selected,and 90 healthy persons were selected as control. The expression of sCD40 level in serum and the correlation with clinical and biochemical indexes were analyzed. Results The serum concentration of sCD40 and the percentage of 25%～75% percentile in liver disease group and control group were significantly different（P〈0.05）. Serum levels of sCD40 in chronic hepatitis group were positively correlated with ALT and AST（r=0.57,0.36,P〈0.05）. Serum sCD40 levels in patients with cirrhosis were positively correlated with alkaline phosphatase（ALP）（r=0.78,P〈0.05）. Among the severe hepatitis patients,the serum levels of sCD40 of the dead cases（231.52±101.98 pg/m L）were significantly higher than those of the survivors（t=2.14,P=0.02）. Serum levels of sCD40（236.56 ± 117.45）pg/m L in patients with concurrent liver disease at the beginning of admission were significantly different from those in patients without concurrent liver disease（120.35±82.41）pg/m L（P〈0.05）. Conclusion In patients with chronic hepatitis B,sCD40 showed abnormally high expression status,and sCD40 could be used to evaluate the degree of liver cell damage and to evaluate the prognosis of liver failure as an immunological indicator.