血清CYP2R1含量对慢性乙肝患者病毒载量及抗病毒的疗效研究

Study of serum CYP2R1 on viral load and antiviral efficacy in patients with chronic hepatitis B

目的探讨维生素D3代谢酶CYP2R1含量对慢性乙型肝炎患者HBVDNA载量及抗病毒疗效的影响。方法收集我院慢性乙型肝炎患者100例。根据患者中位血清CYP2R1含量(26.5 ng/L)分为CYP2R1高浓度组50例和CYP2R1低浓度组50例。2组患者给予恩替卡韦抗病毒治疗12个月,于治疗前、治疗期间第6个月和第12个月时检测患者血清肝功能、乙肝病毒学等相关指标。采用常规生化仪测定血清肝功能,ELISA法测定血清CYP2R1含量,荧光定量聚合酶链反应技术检测HBV DNA含量。结果 2组患者治疗前、治疗6个月、治疗12个月谷草转氨酶(AST)、谷丙转氨酶(ALT)和总胆红素(TBiL)水平依次降低(P<0.05);病毒载量HBV DNA依次降低。治疗前各指标差异均无统计学意义;治疗12个月时,CYP2R1高浓度组患者的病毒载量HBV DNA均低于CYP2R1低浓度组(P<0.05)。结论血清CYP2R1可能通过调节维生素D合成参与机体调控乙型肝炎病毒的复制;高水平CYP2R1提示抗病毒疗效较好。

Objective To investigate the relationship between the content of CYP2 R1,vitamin D3 metabolic enzyme, and the relationship between HBV DNA content and antiviral efficacy in patients with chronic hepatitis B. Methods 100 patients with chronic hepatitis B in our hospital were collected. According to the patient’s median serum CYP2 R1 content(26.5 ng/L), 50 patients in the high concentration group of CYP2 R1 and 50 patients in the low concentration group of CYP2 R1. Two groups of patients were given entecavir antiviral therapy for 12 months. Serum liver function, hepatitis B virology were measured before treatment, 6 and 12 months after treatment. Serum liver function was measured by conventional biochemical analyzer. Serum CYP2 R1 content was determined by ELISA, and HBV DNA content was detected by fluorescence quantitative polymerase chain reaction.Results The levels of aspartate aminotransferase(AST), alanine aminotransferase(ALT) and total bilirubin(TBiL) were decreased in the two groups before treatment, 6 months after treatment and 12 months after treatment(P <0.05);viral load HBV DNA decreased in turn. There was no statistically significant difference in the indexes before treatment;when entecavir was treated for 12 months, the HBV DNA of patients with high CYP2 R1 high concentration group was lower than that with low CYP2 R1 low concentration group(P<0.05). Conclusion Serum CYP2 R1 may participate in the regulation of hepatitis B virus replication through regulation of vitamin D synthesis;patients with high levels of CYP2 R1 can obtain better antiviral efficacy.