慢性乙肝患者血清可溶性黏附分子P-selectin、ICAM-1与病情变化的相关性研究

The correlation of serum soluble adhesion molecules P-selectin and ICAM-1 with change of the illness in patients with chronic hepatitis B

目的:探讨慢性乙肝患者血清可溶性黏附分子P-selectin、ICAM-1与病情变化的相关性。方法:119例慢性乙肝患者根据病情严重程度分为慢性乙肝组(n=83,普通慢性乙肝患者)、重症乙肝组(n=36,重症乙肝患者),另取同期在本院进行体检的健康志愿者50例作为正常对照组。对比3组研究对象血清中可溶性黏附分子P-selectin、ICAM-1以及乙肝病毒载量(HBV-DNA)、肝功能指标(AST、ALT、TP、TBil)、肝纤维化指标(CⅣ、HA、LN)的差异,进一步分析慢性乙肝患者血清P-selectin、ICAM-1含量与上述病情指标的内在联系。结果:慢性乙肝组、重症乙肝组患者血清中P-selectin的含量分别高于正常对照组,ICAM-1的含量分别低于正常对照组,随病情加重P-selectin、ICAM-1血清含量改变加剧。慢性乙肝组、重症乙肝组患者血清HBV-DNA水平分别高于正常对照组,且重症乙肝组患者血清HBV-DNA水平更高;重症乙肝组患者血清中AST、ALT、TBil的水平高于慢性乙肝组、正常对照组,TP的水平低于慢性乙肝组、正常对照组;慢性乙肝组、重症乙肝组患者血清中CⅣ、HA、LN的含量分别高于正常对照组,且重症乙肝组患者血清CⅣ、HA、LN含量更高。相关性分析发现,慢性乙肝患者血清中P-selectin、ICAM-1含量与乙肝病毒载量、肝功能、肝纤维化程度均直接相关。结论:P-selectin在慢性乙肝患者血清中含量异常增高,而ICAM-1含量异常下降,其具体血清含量可用于衡量患者病情严重程度。

Objective: To explore the correlation of serum soluble adhesion molecules P-selectin and ICAM-1 with change of the illness in patients with chronic hepatitis B. Methods: 119 patients with chronic hepatitis B were divided into chronic hepatitis B group ( n=83, patients with normal chronic hepatitis B) and severe hepatitis B group ( n=36, patients with severe hepatitis B) according to the disease severity, and 50 healthy volunteers who received physical examination in our hospital during the same period were chosen as normal control group. The differences in serum soluble adhesion molecules P-selectin and ICAM-1, hepatitis B viral load (HBV-DNA), liver function indexes (AST, ALT, TP and TBil) as well as liver fibrosis indexes (CⅣ, HA and LN) were compared among the three groups, and the inner link of serum P-selectin and ICAM-1 contents with the above disease indexes in patients with chronic hepatitis B was further analyzed. Results: Serum P-selectin contents of chronic hepatitis B group and severe hepatitis B group were higher than that of normal control group respectively while ICAM-1 contents were lower than that of normal control group respectively, and the changes in serum P-selectin and ICAM-1 contents intensified as the patients' condition worsened. Serum HBV-DNA levels of chronic hepatitis B group and severe hepatitis B group were higher than that of normal control group respectively, and serum HBV-DNA level of severe hepatitis B group was higher; serum AST, ALT and TBil levels of severe hepatitis B group were higher than those of chronic hepatitis B group and normal control group while TP level was lower than that of chronic hepatitis B group and normal control group; serum CⅣ, HA and LN contents of chronic hepatitis B group and severe hepatitis B group were higher than those of normal control group respectively, and serum CⅣ, HA and LN contents of severe hepatitis B group were higher. Correlation analysis revealed that serum P-selectin and ICAM-1 contents in patients with chronic hepatitis B were directly correlated with hepatitis B viral load, liver function and liver fibrosis degree. Conclusion: Serum P-selectin content abnormally increases while ICAM-1 content abnormally decreases in patients with chronic hepatitis B, and their serum contents can be used to measure the disease severity.