慢性乙型肝炎及肝硬化患者血清高迁移率族蛋白B1水平变化及临床意义

Level of high-mobility group box 1 in patients with chronic hepatitis B and liver cirrhosis and its clinical significance

目的探讨慢性乙型肝炎患者血清高迁移率族蛋白B1(HMGB1)水平与肝脏炎症活动程度、肝纤维化程度及肝功能各指标的关系。方法选取2015年5月-2016年5月于白求恩国际和平医院和石家庄市第五医院就诊的73例慢性乙型肝炎及肝硬化患者作为研究对象,肝活组织检查确定炎症活动程度及纤维化程度,检测肝功能相关指标及血清HMGB1,分析HMGB1水平与各指标的相关性。2组间比较采用t检验,两指标间的相关性采用直线相关性分析。结果慢性乙型肝炎及肝硬化患者血清HMGB1水平[(29.46±7.54)ng/ml]较健康对照组[(16.86±3.48)ng/ml]明显升高,2组间比较差异有统计学意义(t=5.668,P<0.01)。G3~G4组HMGB1水平显著高于G1~G2组(t=4.441,P<0.01),但S1~S2组HMGB1水平与S3~S4组无明显差异(t=0.658,P>0.05)。血清HMGB1水平与ALT(r=0.256 6,P=0.028 4)及AST(r=0.471 9,P<0.000 1)均呈显著正相关,而与Alb、TBil无相关性(P值均>0.05)。结论血清HMGB1水平与肝脏炎症活动密切相关。

Objective To investigate the correlation of serum high-mobility group box 1（HMGB1） level with hepatic inflammatory activity,liver fibrosis degree,and liver function parameters in chronic hepatitis B patients. Methods A total of 73 patients with chronic hepatitis B and liver cirrhosis were enrolled as subjects. Liver biopsy was performed to determine inflammatory activity and liver fibrosis degree,liver function parameters and serum HMGB1 level were measured,and the correlation between HMGB1 level and other indices was analyzed. The t-test was used for comparison between two groups,and a linear correlation analysis was performed to investigate the correlation between two indices. Results The patients with chronic hepatitis B and liver cirrhosis had a significantly higher HMGB1 level than the healthy control group（29. 46 ± 7. 54 ng/ml vs 16. 86 ± 3. 48 ng/ml,t = 5. 668,P〈0. 01）. The G3-G4 group had a significantly higher HMGB1 level than the G1-G2 group（t = 4. 441,P〈0. 01）,while there was no significant difference in HMGB1 level between the S1-S2 group and the S3-S4 group（t = 0. 658,P〉0. 05）. Serum HMGB1 level was positively correlated with alanine aminotransferase（r = 0. 256 6,P = 0. 028 4） and aspartate aminotransferase（r = 0. 471 9,P〈0. 000 1）,while it was not correlated with albumin or total bilirubin（both P〉0. 05）. Conclusion Serum HMGB1 level is closely correlated with hepatic inflammatory activity.