慢性乙型肝炎患者病毒载量、PD-L1与肝纤维化及肝组织炎症活动度的相关性分析

Correlation Analysis between Viral Load and PD-L1 with Liver Fibrosis and Inflammation Activity of Hepatic Tissues in Patients with Chronic Hepatitis B

目的探讨慢性乙型肝炎(CHB)患者乙型肝炎病毒脱氧核糖核酸(HBV DNA)病毒载量、程序性死亡因子配体1(PD-L1)与肝纤维化、肝组织炎症活动度的相关性。方法回顾性分析2018年4月—2019年4月本院收治的CHB患者102例的临床资料,根据HBeAg表达分为HBeAg阳性组72例和HBeAg阴性组30例。根据肝纤维化程度分组:S1组21例,S2组52例,S3~S4组29例;根据炎症活动度分组:G1组10例,G2组56例,G3~G4组36例。比较各组HBV DNA、PD-L1表达,分析HBV DNA与不同肝纤维化、肝组织炎症活动度之间的关系。结果HBeAg阳性组HBV DNA、PD-L1表达显著高于HBeAg阴性组(P<0.01);不同肝纤维化程度及炎症活动度程度的HBeAg阴性组CHB患者HBV DNA、PD-L1水平比较差异无统计学意义(P>0.05);不同肝纤维化程度及不同炎症活动度程度中HBeAg阳性组CHB患者HBV DNA、PD-L1水平比较差异有统计学意义(P<0.05)。HBeAg阳性CHB患者中,HBV DNA及PD-L1与炎症活动度分级、肝纤维化程度呈正相关(P<0.05)。HBeAg阴性CHB患者中,HBV DNA、PD-L1与炎症活动度分级、炎症活动度分级之间无显著相关性(P>0.05)。结论HBeAg阳性CHB患者中存在HBV DNA、PD-L1高表达,会加重肝纤维化程度及肝组织炎症活动度,HBV DNA、PD-L1可作为HBeAg阳性患者肝纤维化程度及炎症程度的判断指标。而HBeAg阴性患者HBV DNA、PD-L1表达与肝纤维化程度及肝组织炎症活动度之间无显著相关性。

Objective To investigate correlation between hepatitis b virus deoxyribonucleic acid(HBV DNA)viral load and programmed death ligand 1(PD-L1)with liver fibrosis and inflammation activity of hepatic tissues in patients with chronic hepatitis B(CHB).Methods Clinical data of 102 CHB patients admitted during April 2018 and April 2019 was retrospectively analyzed,and they were divided into HBeAg positive group(n=72)and HBeAg negative group(n=30)according to expressions of hepatitis B e antigen(HBeAg).The patients were divided into S1 group(n=21),S2 group(n=52),S3 and S 4 groups(n=29)according to degree of liver fibrosis,and the patients were divided into G1 group(n=10),G2 group(n=56),and G3 and G4 groups(n=36)according to inflammation activity.Expressions of HBV DNA and PD-L1 were compared,and correlations between HBV DNA with different degrees of liver fibrosis and inflammation activities of hepatic tissues were analyzed in all groups.Results Expressions of HBV DNA and PD-L1 in HBeAg positive group were significantly higher than those in HBeAg negative group(P<0.01).There were no statistically significant differences in expressions of HBV DNA and PD-L1 in different degrees of liver fibrosis and inflammatory activity in CHB patients with negative HBeAg(P>0.05).There were statistically significant differences in expressions of HBV DNA and PD-L1 in different degrees of liver fibrosis and inflammatory activity in CHB patients with positive HBeAg(P<0.05).HBV DNA and PD-L1 were positively correlated with grade of inflammation activity and degree of liver fibrosis in CHB patients with positive HBeAg(P<0.05),while there were no significant correlations between HBV DNA and PD-L1 with grade of inflammation activity and degree of liver fibrosis in CHB patients with negative HBeAg(P>0.05).Conclusion High expressions of HBV DNA and PD-L1 in patients with positive HBeAg may aggravate degree of liver fibrosis and inflammation activity of hepatic tissues,and therefore HBV DNA and PD-L1 may be used as indexes in judgement of degree of liver fibrosis and inflammation activity of hepatic tissues in patients with positive HBeAg,while there are no significant correlations between above indexes in patients with negative HBeAg.