血过氧化物酶增殖体激活受体γ与慢性乙型肝炎患者炎症的相关性

The correlation between blood peroxisome proliferator activated receptorγand inflammation of patients with chronic hepatitis B

目的探讨血过氧化物酶增殖体激活受体γ(peroxisome proliferator activated receptorγ,PPAR-γ)与慢性乙型肝炎(chronic hepatits B,CHB)患者炎症的相关性。方法选取2018年1月至2019年8月本院CHB患者300例作为CHB组,选取同期体检健康者100例作为健康组,采用酶联免疫吸附法检测两组研究对象血PPAR-γ及炎症因子[肿瘤坏死因子-α(TNF-α)、白介素6(IL-6)]水平,采用Spearman相关分析分析PPAR-γ与CHB患者肝组织炎症活动度的相关性,采用Pearson相关分析PPAR-γ与炎症因子的相关性。结果CHB组血PPAR-γ[(196.27±25.37)pg/ml]明显低于健康组[(266.71±30.16)pg/ml],血TNF-α、IL-6[(27.43±3.78)ng/ml、(13.31±2.16)ng/ml]明显高于健康组[(8.42±1.09)ng/ml、(6.27±0.78)ng/ml],差异有统计学意义(t=22.897,P<0.001;t=49.571,P<0.001;t=31.884,P<0.001)。CHB组不同肝组织炎症活动分级患者中,G4组患者血PPAR-γ[(125.32±18.38)pg/ml]明显低于G3组[(161.25±20.08)pg/ml],G3组明显低于G2级[(192.34±23.57)pg/ml],G2组明显低于G1组[(223.72±28.93)pg/ml],差异均有统计学意义(P<0.001);CHB组不同肝组织炎症活动度分级患者中,G4组患者血TNF-α、IL-6[(53.41±6.34)ng/ml,(25.68±4.07)ng/ml]明显高于G3组[(41.35±4.93)ng/ml,(18.12±2.85)ng/ml],G3组明显高于G2组[(27.67±3.68)ng/ml,(13.84±1.93)ng/ml],G2组明显高于G1组[(18.16±2.45)ng/ml,(9.25±1.15)ng/ml],差异均有统计学意义(P均<0.001)。Spearman相关分析显示,CHB患者血PPAR-γ与肝组织炎症活动度呈负相关(r=-0.752,P<0.001);Pearson相关分析显示,CHB患者血PPAR-γ与血TNF-α、IL-6、ALT、AST呈负相关(r=-0.721,P<0.001;r=-0.765,P<0.001;r=-0.705,P<0.001;r=-0.685,P<0.001)。结论血PPAR-γ与CHB患者炎症相关,其水平随肝组织炎症活动度增加而下降,可能通过介导TNF-α、IL-6等炎症因子而参与CHB肝组织炎症损伤。

Objective To discuss the correlation between blood peroxisome proliferator activated receptorγ(PPAR-γ)and inflammation of patients with chronic hepatitis B(CHB).Methods From January 2018 to August 2019,300 CHB patients in our hospital were selected as CHB group,and 100 healthy people were selected as healthy group,the blood PPAR-γand inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)]levels were detected by enzyme-linked immunosorbent assay.Spearman correlation analysis was used to analyze PPAR-γcorrelation with inflammatory activity of liver tissue of patients with CHB.Pearson correlation analysis was used to analyze PPAR-γcorrelation with inflammatory factors.Results Blood PPAR-γof CHB group[(196.27±25.37)pg/ml]was significantly lower than that of healthy group[(266.71±30.16)pg/ml],blood TNF-αand IL-6 of CHB group[(27.43±3.78)ng/ml,(13.31±2.16)ng/ml]were significantly higher than those of healthy group[(8.42±1.09)ng/ml,(6.27±0.78)ng/ml],the difference were statistically significant(t=22.897,P<0.001;t=49.571,P<0.001;t=31.884,P<0.001).Among the patients with different degrees of liver inflammation of CHB group,the blood PPAR-γof G4 group[(125.32±18.38)pg/ml]was significantly lower than that of G3 group[(161.25±20.08)pg/ml],G3 group was significantly lower than that of G2 group[(192.34±23.57)pg/ml],G2 group was significantly lower than that of G1 group[(223.72±28.93)pg/ml],the differences were statistically significant(all P<0.001);Among the patients with different degrees of liver inflammation of CHB group,the blood TNF-αand IL-6 of G4 group[(53.41±6.34)ng/ml,(25.68±4.07)ng/ml]were significantly higher than those of G3 group[(41.35±4.93)ng/ml,1(8.12±2.85)ng/ml],G3 group were significantly higher than those of G2 group[(27.67±3.68)ng/ml,(13.84±1.93)ng/ml],G2 group were significantly higher than those of G1 group[(18.16±2.45)ng/ml,(9.25±1.15)ng/ml],the differences were statistically significant(all P<0.001).Spearman correlation analysis showed that,there was negative correlation between PPAR-γand liver inflammatory activity(r=-0.752,P<0.001);Pearson correlation analysis showed that,there were negative correlation between PPAR-γand TNF-α,IL-6,ALT,AST(r=-0.721,P<0.001;r=-0.765,P<0.001;r=-0.705,P<0.001;r=-0.685,P<0.001).Conclusions Blood PPAR-γis related to the inflammation of CHB patients,which decreases with the increase of inflammation activity in liver tissue,and may be involved in the inflammatory damage of liver tissue in CHB by mediating the inflammatory factors of TNF-αand IL-6.