慢性乙型病毒性肝炎血清三叶因子3水平观察及其在不同中医证型中的差异性表达

Observation on serum level of trefoil factor 3 in patients with chronic hepatitis B and its differential expression in different TCM syndromes

目的研究慢性乙型病毒性肝炎(以下简称"慢乙肝")血清三叶因子(trefoil factor, TFF)3水平及其在不同中医证型中的差异性表达,探索慢乙肝诊疗新靶标,助力慢乙肝中医辨证客观化。方法将150例慢乙肝患者设为慢乙肝组,40例健康对照者设为健康对照组,然后根据肝功能水平将150例慢乙肝患者分为肝功能正常组(36例)和肝功能异常组(114例),最后对肝功能异常的114例慢乙肝患者进行中医辨证,并据此分为虚证组(59例)和实证组(55例)。采用全自动生化分析仪测定肝功能,ELISA法检测TFF3、炎症因子水平,比较慢乙肝患者与健康对照者、不同肝功能水平慢乙肝患者、不同中医证型慢乙肝患者的血清TFF3水平,并分析肝功能、炎症因子与血清TFF3的相关性。结果 (1)与健康对照组比较,慢乙肝组患者血清TFF3水平升高(P<0.01);与慢乙肝虚证患者比较,慢乙肝实证患者血清TFF3水平降低(P<0.05);不同肝功能水平的慢乙肝患者血清TFF3水平比较,差异无统计学意义(P>0.05)。(2)相关性研究结果显示,慢乙肝患者血清TFF3水平与丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、肿瘤坏死因子-α(TNF-α)水平不具有相关性,与白介素-10(IL-10)、白介素-1β(IL-1β)水平呈正相关,但相关系数较低(r=0.193,P=0.020;r=0.223,P=0.007)。结论 TFF3在慢乙肝患者血清中的表达水平升高,且虚证患者较实证患者更为明显;推测TFF3可能参与慢乙肝免疫应答调控,有望成为慢乙肝的诊疗新靶标及中医辨证的客观化依据。

Objective To study the serum level of trefoil factor(TFF) 3 in patients with chronic hepatitis B(CHB) and its differential expression in different traditional Chinese medicine(TCM) syndromes, explore new targets for diagnosis and treatment of CHB, and help the objectification of TCM syndrome differentiation of CHB. Methods First, 150 patients with CHB were set as CHB group, and 40 healthy people were set as healthy control group. Then, 150 patients with CHB were divided into normal liver function group(n=36) and abnormal liver function group(n=114) according to the condition of liver function. Finally, 114 patients with abnormal liver function were divided into deficiency syndrome group(n=59) and excess syndrome group(n=55) according to TCM syndrome differentiation. We used automatic biochemical analyzer to measure liver function, ELISA to detect the levels of TFF3 and inflammatory factors, compared the serum level of TFF3 in CHB patients with that in healthy controls, CHB patients with different liver function levels, and CHB patients with different TCM syndromes,and analyzed the correlation between liver function,inflammatory factors and serum TFF3. Results(1)The serum level of TFF3 in patients with CHB increased compared with that of healthy controls( P < 0. 01). The serum level of TFF3 in CHB patients of the excess syndrome group decreased compared with that in patients of the deficiency syndrome group( P<0.05). There was no significant difference in serum level of TFF3 among CHB patients with different liver function levels( P>0.05).(2)The results of correlation study showed that serum level of TFF3 in CHB patients had no correlation with levels of alanine aminotransferase( ALT),aspartate aminotransferase( AST),and tumor necrosis factor-α( TNF-α),while it was positively correlated with interleukin-10( IL-10) and interleukin-1β( IL-1β) levels with low the correlation coefficient( r = 0. 193,P = 0. 020;r = 0. 223,P = 0. 007).Conclusion The serum expression level of TFF3 in CHB patients rises,which could be observed more obviously in patients with deficiency syndrome than in those with excess syndrome. It is speculated that TFF3 may be involved in the regulation of immune response of CHB,which is expected to become a new target for diagnosis and treatment of CHB and an objective basis for TCM syndrome differentiation.