老年乙型肝炎病毒相关肝硬化患者血清成纤维细胞生长因子21水平的变化及其与肝功能的相关性

The change in serum fibroblast growth factor 21 level and its correlation with liver functions in elderly patients with hepatitis B virus related cirrhosis

目的探讨乙型肝炎病毒(HBV)相关老年肝硬化患者成纤维细胞生长因子21(FGF21)的表达及其与肝功能指标的相关性。方法选择北京地坛医院和中日友好医院2019年1月至2020年12月收治的150例老年HBV感染者作为研究对象,按照其病变类型分为慢性乙型肝炎(CHB)组70例及HBV相关肝硬化组80例.选择同期50例健康体检者为对照组。记录并比较各组患者的一般资料和实验室指标,采用酶联免疫吸附(ELISA)法测定血清FGF21.比较不同肝功能分级患者FGF21的水平.采用Pearson相关分析FGF21水平与肝功能指标的相关性。结果HBV相关肝硬化组患者的总胆红素(TBil)和总胆汁酸(TBA)高于CHB组,HBV相关肝硬化组的血清天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、谷氨酰转移酶(GGT)水平、白蛋白、胆碱酯酶、FGF21水平和HBV-DNA水平低于CHB组(均P<0.05)。HBV相关肝硬化组患者中Child-Pugh A级、B级和C级患者血清FGF21水平分别为(108.6±7.3)ng/L.(92.5±7.6)ng/L.(75.8±6.3)ng/L;随Child-Pugh分级的增高FGF21水平降低(F=18.290、P=0.000)。血清FGF21与AST、ALT、TBil、胆碱酯酶和白蛋白水平呈正相关(r=0.652、0.579、0.609.0.558.0.613.均p<0.05)。结论HBV相关老年肝硬化患者血清FGF21水平的表达显著降低,且和肝功能指标呈正相关。

Objective To study the change in serum fibroblast growth factor 21(FGF21)level and its correlation with liver funetions in elderly patients with hepatitis B virus(HBV)-related cirrhosis.Methods A total of 150 elderly patients with HBV infection admitted to Beijing Ditan Hospital and China Japan Friendship Hospital from January 2019 to December 2020 were selected and divided into chronic hepatitis B(CHB)group(n=70)and HBV-related cirrhosis group(n=80).Healthy subjects were selected as the control group(n=50).Serum FGF21 was determined by ELISA method.Clinical data.clinical laboratory indicators and FGF21 as a core parameter of this study were collected and compared among control group.CHB group.HBV related cirrhosis group.The correlations of FGF21 level with several liver function indexes were analyzed by Pearson correlation analysis.Results The levels of total bilirubin(TBil)and total biliary acid(TBA)were significantly higher in HBV-related cirrhosis group than in CHB group.The levels of aspartale transaminase(AST).alanine transaminase(ALT).glutamyl transpeptadase(GGT).serum albumin.cholinesterase.FGF21 and HBV-DNA were significantly lower in HBV-related cirrhosis group than in CHB group(all P<0.05).The levels of serum FGF21 were(108.6±7.3)ng/1.(92.5±7.6)ng/L and(75.8±6.3)ng/L in Child Pugh A.B and C patients,respectively.The level of FGF21 was statistically significantly decreased with the increase of Child-Pugh grading(F=18.290,P=0.000).Serum FGF21 level was positively correlated with AST.ALT.TBil,cholin-esterase and albumin levels(r=0.652.0.579.0.609.0.558.0.613.all P<0.05).Conclusions The level of serum FGF21 is significantly decreased in elderly patients with HBV-related cirrhosis,and is positively correlated with liver function indexes.