乙型肝炎病毒感染相关肝病患者血清T淋巴细胞免疫球蛋白黏蛋白分子-3、高尔基体蛋白73变化及其临床意义的研究

Observation on the changes and clinical significance study of serum T lymphocyte immunoglobulin mucin-3 and Golgi protein 73 in patients with hepatitis B virus infection related liver diseases

目的:探讨乙型肝炎病毒(HBV)感染相关肝病患者血清T淋巴细胞免疫球蛋白黏蛋白分子-3(TIM-3)、高尔基体蛋白73(GP73)变化及其临床意义。方法:选取2020年9月至2022年10月于河南省郑州市第三人民医院诊治的100例HBV感染相关肝病患者为研究对象,其中47例慢性乙型肝炎(CHB)、35例肝硬化(LC)、18例肝细胞癌(HCC),分别纳入CHB组、LC组、HCC组,另选取本院同期体检的30例健康者纳入对照组。根据病情严重程度不同,CHB组又分为轻度CHB组(16例)、中度CHB组(19例)和重度CHB组(12例),LC组又分为代偿期LC组(15例)和失代偿期LC组(20例),HCC组又分为甲胎蛋白(AFP)阴性HCC组(8例)和AFP阳性HCC组(10例)。比较CHB组、LC组、HCC组和对照组TIM-3、GP73、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、白蛋白和总胆红素(TBil)水平;比较CHB亚组、LC亚组和HCC亚组患者TIM-3、GP73水平;分析HBV感染相关肝病患者TIM-3和GP73与ALT、AST、白蛋白及TBil的相关性。结果:四组TIM-3、GP73、ALT、AST、白蛋白和TBil水平比较,差异有统计学意义(P<0.001);CHB组、LC组和HCC组TIM-3、GP73、ALT、AST及TBil水平均高于对照组,白蛋白水平均低于对照组(P<0.05);LC组和HCC组TIM-3、GP73、ALT、AST及TBil水平均高于CHB组,白蛋白水平均低于CHB组(P<0.05);HCC组TIM-3、GP73、ALT、AST及TBil水平均高于LC组,白蛋白水平低于LC组(P<0.05)。轻度CHB组、中度CHB组、重度CHB组TIM-3和GP73水平比较,差异有统计学意义(P<0.001);中度CHB组、重度CHB组TIM-3和GP73水平均高于轻度CHB组(P<0.05);重度CHB组TIM-3和GP73水平均高于中度CHB组(P<0.05)。失代偿期LC组TIM-3、GP73水平均高于代偿期LC组(P<0.05)。AFP阳性HCC组TIM-3、GP73水平均高于AFP阴性HCC组(P<0.05)。CHB组、LC组、HCC组患者TIM-3、GP73与ALT、AST、TBil呈正相关,与白蛋白呈负相关(P<0.05)。结论:HBV感染相关肝病患者血清TIM-3、GP73水平明显升高,CHB、LC、HCC不同疾病发展阶段其表达水平升高程度显著,且与病情发展及肝功能损伤密切相关。

Objective:To observe the changes and clinical significance of serum T lymphocyte immunoglobulin mucin-3(TIM-3)and Golgi protein 73(GP73)in patients with hepatitis B virus(HBV)infection related liver diseases.Methods:A total of 100 patients with HBV infection related liver diseases treated in the 3rd People’s Hospital of Zhengzhou from September 2020 to October 2022 were selected,including 47 cases of hepatitis B(CHB),35 cases of liver cirrhosis(LC),and 18 cases of hepatocellular carcinoma(HCC).They were included in the CHB,LC,and HCC groups.Another 30 healthy individuals who underwent physical examination in this hospital during the same period were included in the control group.According to the severity of the condition,the CHB group was subdivided into mild CHB group(n=16),moderate CHB group(n=19),and severe CHB group(n=12).The LC group was further subdivided into compensatory LC group(n=15)and decompensated LC group(n=20).The HCC group was subdivided into alpha fetoprotein(AFP)negative HCC group(n=8)and AFP positive HCC group(n=10).The levels of TIM-3,GP73,alanine aminotransferase(ALT),aspartate aminotransferase(AST),albumin(ALB),and total bilirubin(TBil)in CHB group,LC group,HCC group and control group were compared.The levels of TIM-3 and GP73 in each subgroups(CHB sub-group,LC sub-group and HCC sub-group)were compared and their correlation with ALT,AST,ALB,and TBil in patients with HBV infection-related liver disease was analyzed.Results:The levels of TIM-3,GP73,ALT,AST,and TBil among the four groups(P<0.05).The levels of TIM-3,GP73,ALT,AST and TBil in CHB,LC and HCC groups were higher than those in control group,and the albumin levels were lower than those in control group(P<0.05).The levels of TIM-3,GP73,ALT,AST and TBil in LC group and HCC group were higher than those in CHB group,and the albumin levels were lower than those in CHB group(P<0.05).TIM-3,GP73,ALT,AST and TBil levels in HCC group were higher than those in LC group,while albumin levels were lower than those in LC group(P<0.05).The levels of TIM-3 and GP73 in mild CHB group,moderate CHB group and severe CHB group were significantly different(P<0.05).TIM-3 and GP73 levels in moderate CHB group and severe CHB group were higher than those in mild CHB group(P<0.05).TIM-3 and GP73 levels in severe CHB group were higher than those in moderate CHB group(P<0.05).The levels of TIM-3 and GP73 in decompensated LC group were higher than those in compensated LC group(P<0.05).The levels of TIM-3 and GP73 in the AFP positive HCC group were higher than those in the AFP negative HCC group(P<0.05).TIM-3 and GP73 in CHB group,LC group,and HCC groups were positively correlated with ALT,AST,and TBil,while negatively correlated with albumin(P<0.05).Conclusions:The levels of serum TIM-3 and GP73 are significantly elevated in patients with HBV infection related liver diseases,and the expression levels of CHB,LC,and HCC are significantly elevated at different stages of disease development,and are closely related to disease progression and liver function damage.