慢性乙型肝炎患者血清C-C趋化因子22及其受体的表达和临床意义

Expression and clinical significance of serum CCL22 and CCR4 in patients with chronic hepatitis B

目的 探讨慢性乙型肝炎(chronic hepatitis B, CHB)患者血清C-C趋化因子22(C-C chemokine 22, CCL22)及其受体(C-C chemokine receptor 4, CCR4)表达,以及与肝功能指标和病情发展程度的相关性。方法 选取2021年10月-2022年11月在内江市中医医院就诊的96例慢性乙型肝炎患者作为观察组,根据病情进展分为轻度组(n=43)、中度组(n=36)和重度组(n=17),另选取同期在本院进行体检的健康者50例作为对照组。检测血清CCL22 mRNA、CCR4mRNA和肝功能指标[丙氨酸氨基转移酶(alanine aminotrans-ferase, ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase, AST)、总胆红素(total bilirubin, TBIL)和白蛋白(albumin, ALB)]水平,采用Pearson相关性分析血清CCL22和CCR4水平与肝功能指标和病情程度的相关性,采用Logistic回归分析CHB患者病情进展的影响因素。结果 与对照组相比,观察组患者CCL22 mRNA、CCR4 mRNA、ALT、AST和TBIL水平上升(P<0.05),ALB水平下降(P<0.05);轻度组、中度组和重度组患者血清CCL22 mRNA、CCR4 mRNA、ALT、AST和TBIL表达水平依次升高,ALB表达水平依次降低,组间比较差异有统计学意义(P<0.05);血清CCL22 mRNA和CCR4 mRNA与肝功能指标ALT、AST、TBIL水平均呈正相关,与ALB水平呈负相关(P<0.05);CCL22 mRNA、CCR4 mRNA与患者病情严重程度呈正相关(r=0.646、0.516,P<0.001);CCR4 mRNA、ALT、AST、TBIL和ALB表达水平均为CHB患者病情发展的影响因素(P<0.05)。结论 血清CCL22和CCR4表达与CHB患者肝功能指标和病情严重程度相关,可为临床病情评估和对症治疗提供参考依据。

Objective To investigate the expression of serum C-C chemokine 22(CCL22)and its receptor C-C chemokine receptor 4(CCR4)in patients with chronic hepatitis B(CHB),and its correlation with liver function indicators and disease progression.Methods A total of 96 patients with CHB who were treated in Neijiang Traditional Chinese Medicine Hospital from October 2021 to November 2022 were recruited as the observation group,and divided into mild group(n=43),moderate group(n=36)and severe group(n=17),according to the progress of the disease.In addition,50 healthy people who underwent physical examination in the same hosiptal were selected as the control group.The levels of serum CCL22 mRNA,CCR4 mRNA and liver function indicators[alanine aminotrans-ferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)and albumin(ALB)]were measured.Pearson correlation analysis was performed to analyze the correlation between serum CCL22 and CCR4 levels and liver function indicators and disease severity,and logistic regression was applied to evaluate the factors affecting the progress of CHB patients.Results Compared with the control group,the levels of CCL22 mRNA,CCR4 mRNA,ALT,AST and TBIL in the observation group were obviously higher(P<0.05),the level of ALB was obviously lower(P<0.05);the expression levels of serum CCL22 mRNA,CCR4 mRNA,ALT,AST and TBIL in mild,moderate and severe groups increased in turn,while the expression level of ALB decreased in turn,with significant differences between groups(P<0.05);The levels of serum CCL22 mRNA and CCR4 mRNA were positively correlated with liver function indicators ALT,AST,TBIL levels,and negatively correlated with ALB level(P<0.05);Both CCL22 mRNA and CCR4 mRNA were positively correlated with the severity of the disease(r=0.646,0.516,P<0.001);the expression levels of CCR4 mRNA,ALT,AST,TBIL and ALB were all factors affecting the development of CHB patients(P<0.05).Conclusions The expression of CCL22 and CCR4 in serum is closely related to liver function index and severity of CHB patients,which can provide reference for clinical evaluation and symptomatic treatment.