CD68在慢性乙型肝炎发病机制的临床初步研究

Preliminary clinical study of CD68 in the pathogenesis of chronic hepatitis B

目的分析健康人群和慢性乙型肝炎(CHB)患者CD68表达情况,研究CD68表达与乙型肝炎病毒(HBV)血清学、肝功能等相关性。方法分析血清、外周血单个核细胞(PBMC)CD68含量及mRNA表达水平;采用免疫组化染色技术分析PBMC与肝组织CD68表达情况;运用实时荧光定量PCR检测患者外周血病毒载量及其基因分型。分别以t检验和Pearson相关性检验分析CD68在CHB患者与健康对照血清中差异及其与其它指标相关性。结果与健康对照组比较,CHB组血清CD68含量显著升高,且与HBV DNA载量、ALT、AST水平呈显著正相关性(r=0.355 0,P=0.0014;r=0.345 0,P=0.002 0;r=0.328 9,P=0.003 3),而与乙肝表面抗原(HBsAg)含量、HBV基因分型及乙肝e抗原(HBeAg)状态无相关性(r=0.085,P=0.459;t=1.251,P=0.215;t=1.293,P=0.200)。CD68在CHB组和健康对照组PBMC中mRNA和蛋白表达水平差异无统计学意义,但CHB组肝组织CD68含量显著高于健康对照组。结论 CHB患者CD68与病毒复制及肝细胞损伤密切相关,且在肝组织呈现较高表达,提示CD68在慢性乙型肝炎发病机制中可能具有重要作用。

Objective To investigate the levels of CD68 in healthy controls and patients with chronic hepatitis B（CHB）,and analyze whether it is associated with HBV markers as well as liver function indexes. Methods The levels of CD68 in serum and peripheral blood mononuclear cell（ PBMC） were analyzed. Both the expression of CD68 in PBMC and hepatic tissue specimens were used to analyze by immunohistochemical（ IHC） methods. Moreover,HBV DNA load and HBV genotype were detected by Real-Time PCR. The serum and PBMC levels of CD68,liver function indexes in patients with CHB and healthy controls were compared by t test. Meanwhile,the association between CD68 with HBV markers and liver function indexes were analysed using by Pearson correlation test.Results Compared with healthy controls,serum CD68 levels in patients with CHB were significantly increased,and positively correlated with HBV DNA load,ALT and AST,respectively（ r = 0. 355 0,P = 0. 001 4;r = 0. 345 0,P = 0. 002 0;r = 0. 328 9,P = 0. 003 3）. In contrast,there was no correlation between CD68 with hepatitis B surface antigen（ HBs Ag） quantification,HBV genotype and hepatitis B e antigen（ HBe Ag） status（ r = 0. 085,P =0. 459;t = 1. 251,P = 0. 215;t = 1. 293,P = 0. 200）. There was no significant difference of CD68 in PBMC between CHB patients and healthy controls. However,the expression of CD68 in liver specimens of CHB patients was markedly higher than that in healthy controls. Conclusion The CD68 concentrations closely relate to HBV replication and liver injury in patients with CHB,especially high expression in liver of CHB patients,suggesting that it might plays an important roles of pathogenesis in CHB patients.