摘要
目的分析血清乙型肝炎病毒(HBV)-DNA载量对乙型肝炎(以下简称乙肝)患者肝功能及外周血内质网应激(ERS)相关指标的影响,为乙肝的临床诊治提供依据。方法选取2016年7月—2017年6月在唐山市传染病医院治疗的乙肝患者136例。按血清HBV-DNA载量将患者分为阴性组(血清HBV-DNA载量<1.0×10~3 copies/ml)、低拷贝组(1.0×10~3 copies/ml≤血清HBV-DNA载量<1.0×10~5 copies/ml)、中拷贝组(1.0×10~5 copies/ml≤血清HBV-DNA载量<1.0×10~7 copies/ml)、高拷贝组(血清HBV-DNA载量≥1.0×10~7 copies/ml)。同期选取在唐山市传染病医院治疗的非HBV感染患者82例为对照组。检测并比较5组血清HBV-DNA载量、肝功能指标[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(γ-GT)、碱性磷酸酶(ALP)]、ERS相关指标[葡萄糖调节蛋白78(GRP78)、CCAAT/增强子结合蛋白(CHOP)、天冬半胱氨酸特异性蛋白酶-12(caspase-12)],分析肝功能指标与血清HBV-DNA载量及ERS相关指标的相关性。结果 5组ALP比较,差异无统计学意义(P>0.05);低拷贝组、中拷贝组、高拷贝组ALT、AST高于对照组、阴性组(P<0.05);中拷贝组、高拷贝组ALT、AST高于低拷贝组(P<0.05);高拷贝组ALT、AST高于中拷贝组(P<0.05);阴性组、低拷贝组、中拷贝组、高拷贝组γ-GT高于对照组(P<0.05)。阴性组、低拷贝组、中拷贝组、高拷贝组GRP78、CHOP、caspase-12高于对照组(P<0.05);低拷贝组GRP78低于阴性组(P<0.05);中拷贝组GRP78高于低拷贝组(P<0.05)。ALT、AST与血清HBV-DNA载量均呈正相关(P<0.05);γ-GT、ALP与血清HBV-DNA载量无直线相关关系(P>0.05)。ALT、AST、γ-GT、ALP与GRP78、CHOP、caspase-12均无直线相关关系(P>0.05)。结论乙肝患者血清HBV-DNA载量可对肝功能产生影响,且可诱发外周血ERS,这对乙肝的发病机制研究及临床诊治有一定的现实指导意义。
Objective To analyze the effect of serum hepatitis B virus(HBV)-DNA load on liver function and endoplasmic reticulum stress(ERS)in peripheral blood in patients with hepatitis B,so as to provide evidence for clinical diagnosis and treatment of HBV.Methods A total of 136 cases of patients with hepatitis B admitted to Tangshan Infectious Disease Hospital from July 2016 to June 2017 were enrolled and were divided into negative group(serum HBV-DNA load<1.0×103 copies/ml),low copy group(1.0×103 copies/ml≤Serum HBV-DNA load<1.0×105 copies/ml),medium copy group(1.0×105 copies/ml≤Serum HBV-DNA load<1.0×107 copies/ml),and high copy group(serum HBV-DNA load≥1.0×107 copies/ml).A total of 82 non-HBV infection patients admitted to Tangshan Infectious Disease Hospital were selected as the control group.Serum HBV-DNA load,liver function indexes〔alanine aminotransferase(ALT),aspartic acid aminotransferase(AST),Gamma transglutaminase(γ-GT),alkaline phosphatase(ALP)〕,ERS-related indexes〔glucose regulation protein(GRP78),CCAAT/-enhanced protein(CHOP)and cysteine aspartyl-specific protease-12(caspase-12)〕were detected and compared in 5 groups.The correlation of liver function index with serum HBV-DNA load and ERS-related indexes was analyzed.Results There was no significant difference in ALP in 5 groups(P>0.05).ALT and AST in low copy group,medium copy group and high copy group were higher than those in control group and negative group(P<0.05).ALT and AST in medium copy group and high copy group were higher than those in low copy group(P<0.05).ALT and AST in high copy group were higher than those in medium copy group(P<0.05).γ-GT in negative group,low copy group,medium copy group and high copy group was higher than that in the control group(P<0.05).GRP78,CHOP,caspase-12 in negative group,low copy group,medium copy group and high copy group were higher than those in control group(P<0.05).GRP78 in low copy group was lower than that in negative group(P<0.05),and GRP78 in medium copy group was higher than that in low copy group(P<0.05).ALT and AST were positively correlated with serum HBV-DNA load(P<0.05),γ-GT and ALP had no linear correlation with serum HBV-DNA load(P>0.05).There was no linear correlation between ALT,AST,γ-GT,ALP and GRP78,CHOP and caspase-12(P>0.05).Conclusion The serum HBV-DNA load in patients with hepatitis B can affect the liver function and induce ERS in peripheral blood,which has a certain practical guiding significance for pathogenesis,clinical diagnosis and treatment of hepatitis B.
作者
刘芳
闫宇
李雅楠
戴亮
肖永红
LIU Fang;YAN Yu;LI Ya-nan;DAI Liang;XIAO Yong-hong(School of Public Health,North China University of Science and Technology,Tangshan 063210,China;School of Clinical Medicine,North China University of Science and Technology,Tangshan 063210,China;Department of General Surgery,North China University of Science and Technology Affiliated Hospital,Tangshan 063000,China)
出处
《中国全科医学》
CAS
北大核心
2018年第27期3329-3333,共5页
Chinese General Practice
关键词
乙型肝炎
乙型肝炎病毒
内质网应激
肝功能
Hepatitis B
Hepatitis B virus
Endoplasmic reticulum stress
Liver function