肝硬化食管胃底静脉曲张破裂出血患者外周血单个核细胞中TMEM16A的表达水平及意义

Expression and significance of TMEM16A in peripheral blood mononuclear cells in patients with liver cirrhosis and esophagogastric varices bleeding

目的探究肝硬化食管胃底静脉曲张破裂出血(EGVB)患者外周血单个核细胞中跨膜蛋白16A(TMEM16A)的表达水平及意义。方法选择2016年2月至2019年12月在廊坊市第四人民医院就诊的206例EGVB患者作为研究对象。采用密度梯度离心法获取外周血中单个核细胞。采用蛋白质印迹法检测单个核细胞中TMEM16A的表达水平,并分析其与EGVB患者预后的关系。结果206例EGVB患者中97例(47.09%)预后不良。预后良好组TMEM16A的表达水平高于预后不良组,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,Child-Pugh分级、MELD评分和白细胞计数是EGVB患者预后的独立危险因素(P<0.05),而白蛋白、血钠和TMEM16A是独立保护因素(P<0.05)。限制性立方样条分析结果表明TMEM16A与EGVB患者预后有关(P<0.05),且呈非线性关系(非线性检验P<0.05)。与TMEM16A=0.57比较,TMEM16A<0.57时预后不良风险较高,TMEM16A>0.57时预后不良风险较低。结论EGVB患者外周血单个核细胞中TMEM16A表达水平低提示其预后不良风险较高,检测其表达水平有助于评估患者预后情况。

Objective This paper attempts to investigate the level and significance of transmembrane protein 16A(TMEM16A)in peripheral blood mononuclear cells in patients with liver cirrhosis and esophagogastric varices bleeding.Methods From February 2016 to December 2019,two hundred and six patients with liver cirrhosis and esophagogastric varices bleeding who were treated in the Fourth People′s Hospital of Langfang were selected as the research subjects.Mononuclear cells in peripheral blood were obtained by density gradient centrifugation.TMEM16A levels in mononuclear cells were detected by Western blotting to analyze its relationship with the prognosis of patients with liver cirrhosis and esophagogastric varices bleeding.Results Out of 206 patients with cirrhosis and esophagogastric varices bleeding,97 patients(47.09%)had a poor prognosis.The TMEM16A level in the favorable prognosis group was higher than that in the poor prognosis group,and the difference was statistically significant(P<0.05).The results of logistic regression analysis showed that the Child-Pugh grade,the MELD score,and the white blood cell count were independent risk factors for the prognosis of patients with liver cirrhosis and esophagogastric varices bleeding(P<0.05)while albumin,serum sodium and TMEM16A were independent protective factors(P<0.05).The results of restrictive cubic spline analysis showed that TMEM16A was related to the prognosis of patients with hepatic cirrhosis and esophagogastric varices bleeding(P<0.05),with a nonlinear relationship(non-linear test P<0.05).When TMEM16A<0.57,compared with TMEM16A=0.57,the risk of poor prognosis was high.However,when TMEM16A>0.57,compared with TMEM16A=0.57,the risk of poor prognosis was low.Conclusion The low level of TMEM16A in peripheral blood mononuclear cells of patients with liver cirrhosis and esophagogastric varices bleeding indicates a high risk of poor prognosis,and the detection of this level is conducive to evaluating the prognosis of patients.