乙型肝炎病毒相关慢加急性肝衰竭患者血清miRNA差异表达谱及其预后预测价值

Differential expression and prognostic value of serum miRNA in patients with hepatitis B virus-related acute-on-chronic liver failure

目的 探讨乙型肝炎病毒相关慢加急性肝衰竭(hepatitis B virus-related acute-on-chronic liver failure,HBVACLF)患者血清微小RNA(miRNA)差异表达谱及其对预后的预测价值。方法 选取2018年5月至2019年5月在广州医科大学附属市八医院住院的HBV感染患者55例,其中HBV-ACLF组30例、慢性乙型肝炎(chronic hepatitis B,CHB)组20例,另设立健康对照(health control,HC)组25例,分析3组患者miRNA表达差异情况,及HBV-ACLF患者好转组与未愈组miRNA表达差异情况。结果 75例研究对象中,男59例,女16例,年龄(39.7±9.1)岁;HBV-ACLF组好转17例,未愈13例。3组性别、年龄、肌酐水平及白细胞计数差异无统计学意义(P>0.05);HBV-ACLF组与CHB组、HC组比较,具有较低的红细胞计数、血红蛋白水平、血小板计数及较高ALT、AST水平,且miRNA-144-3P、miRNA-205-5p、miRNA-96-5p、miRNA451a表达上调,差异均有统计学意义(均P<0.05)。HBV-ACLF好转组与未愈组比较,miRNA-205-5p、miRNA-96-5p均为上调表达,差异有统计学意义(P<0.05)。结论 与CHB患者及健康人群相比,HBV-ACLF患者miRNA表达谱存在差异;miRNA205-5p及miRNA96-5p高表达可能预示着HBV-ACLF患者预后良好。

Objective To investigate the prognostic value of serum miRNA in hepatitis B virus-related chronic and acute liver failure(HBV-ACLF),and to guide clinical diagnosis and treatment.Methods Patients with hepatitis B virus infection admitted to our hospital from May 2018 to May 2019 were enrolled.All the patients were divided into HBV-ACLF group and chronic hepatitis B(CHB)group,a health control(HC)group was also established.The differential expression of miRNA among the 3 groups were analyzed.Results A total of 75 patients(59 males and 16 females)were included,with an average age of 39.7±9.1 years.There were 30 patients in HBV-ACLF group(17 cases were improved and 13 cases were not cured),20 cases in CHB group and 25 cases in HC group.There was no significant difference in sex,age,creatinine level and white blood cell count among the 3 groups(P>0.05).Compared with cases in CHB group and HC group,patients in HBV-ACLF group had lower erythrocyte count,hemoglobin level and platelet count(P<0.001),higher levels of alanine aminotransferase,aspartate aminotransferase(P<0.001).The expression levels of miRNA-144-3P,miRNA-205-5p,miRNA-96-5p and miRNA451a were significantly up-regulated in HBV-ACLF group(P<0.05).In HBV-ACLF group,the expression levels of miRNA-205-5p and miRNA-96-5p in patients with condition improved were up-regulated,the difference was statistically significant(P<0.05).Conclusion The miRNA expression profiles in patients with HBV-ACLF is significantly different from that in CHB patients and healthy people.High expression of miRNA 205-5p and miRNA 96-5p in patients with HBV-ACLF may indicate a good prognosis.