目的研究慢性乙型肝炎病毒(hepatitis B virus,HBV)感染自然史不同阶段血清乙型肝炎病毒表面抗原(hepatitis B virus surface antigen,HBsAg)水平及与血清HBV-DNA载量相关性的变化。方法收集2018年~2019年西京医院确诊的未经抗病毒治疗...目的研究慢性乙型肝炎病毒(hepatitis B virus,HBV)感染自然史不同阶段血清乙型肝炎病毒表面抗原(hepatitis B virus surface antigen,HBsAg)水平及与血清HBV-DNA载量相关性的变化。方法收集2018年~2019年西京医院确诊的未经抗病毒治疗的慢性HBV感染患者128例,根据《慢性乙型肝炎防治指南》中HBV感染的自然史标准划分为四组:免疫耐受期27例,免疫清除期30例,低复制期48例和再活动期23例,采用化学发光法及荧光PCR定量法分别检测患者血清HBsAg定量值和血清HBV-DNA载量,分析不同阶段血清HBsAg水平及与HBV-DNA载量的相关性。结果不同阶段血清HBsAg水平分别为:免疫耐受期(3.03~5.38)lg IU/ml、免疫清除期(-0.76~5.09)lg IU/ml、低复制期(-0.88~4.27)lg IU/ml和再活动期(-1.22~4.61)lg IU/ml,各期间差异有统计学意义(F=10.80,P<0.001)。组间比较,免疫耐受期血清HBsAg水平与其他三期差异均有统计学意义(t=2.757~6.092,均P<0.01),免疫清除期血清HBsAg水平与低复制期差异有统计学意义(t=2.630,P=0.010),其余各组间血清HBsAg水平差异无统计学意义(P>0.05)。慢性HBV感染自然史血清HBsAg水平与HBV-DNA载量总体呈正相关(r=0.517,P<0.001),不同阶段两者仅在低复制期无相关性(r=0.288,P=0.121),其他各期均呈正相关(r=0.467~0.672,均P<0.05)。血清HBsAg/HBV-DNA比值在免疫耐受期、免疫清除期及再活动期的均值分别为0.539,0.502及0.600,三者差异无统计学意义(P>0.05)。低复制期该比值均值为1.066,较其他三期明显升高且差异有统计学意义(t=4.223~6247,均P<0.001)。结论慢性HBV感染自然史不同阶段血清HBsAg呈动态变化,低复制期血清HBsAg水平与HBV DNA载量无相关性且两者比值较其他三期明显升高,这一特征可为临床评估慢性HBV感染者的自然病程提供更多依据。展开更多
Background Sepsis is a leading cause of death in the intensive care units. The late inflammatory cytokine, high-mobility group box 1 （HMGB1）, plays a critical role in sepsis. In the present study, we investigated th...Background Sepsis is a leading cause of death in the intensive care units. The late inflammatory cytokine, high-mobility group box 1 （HMGB1）, plays a critical role in sepsis. In the present study, we investigated the association between the serum HMGB1 levels and the severity of organ injury in the lipopolysaccharide-induced sepsis in rats. Methods To produce an animal model of sepsis with different degree of organ injury, animals were treated with three different doses of lipopolysaccharide （4, 8 and 16 mg/kg）, and the animals in control group were treated with the same volume of the vehicle （saline）. The levels of serum HMGB1 were measured at 0, 2, 4, 8, 16, 24, 32 and 48 hours after lipopolysaccharide （LPS） or vehicle injection, meanwhile the biochemical and histopathological indicators for the severity of organ injury were assessed. Results The level of HMGB1 had a positive, high correlation with the abnormal changes of serum cardiac troponin I, alanine aminotransferase, aspartate aminotransferase, creatinine and blood urea nitrogen, as well as the pathologic scores of heart, lung, liver and kidney. Conclusions The level of serum HMGB1 is highly correlated with the severity of sepsis in rats, suggesting that HMGB1 could serve as a valuable adjunct in the diagnosis and management of sepsis.展开更多
基金This work was supported by the grants from the National Natural Science Foundation of China （No.30471675, No.30672041 and No.30725039） the National Natural Science Foundation of Shaanxi Province （No.2004KI7-GI5） and the National Natural Science Foundation of PLA （No.06G086）.We are grateful to Drs. LI Qing and HUI Yan-ping （Department of Pathology, Fourth Military Medical University） for assisting in histopathological analysis+1 种基金 to Dr. SHANG Lei （Department of Health Statistics, Fourth Military Medical University） for his help in the statistics analysis to Dr. LIU Shan-lu （Department of Microbiology and Immunology, McGill University） for his insightful comments.
文摘Background Sepsis is a leading cause of death in the intensive care units. The late inflammatory cytokine, high-mobility group box 1 （HMGB1）, plays a critical role in sepsis. In the present study, we investigated the association between the serum HMGB1 levels and the severity of organ injury in the lipopolysaccharide-induced sepsis in rats. Methods To produce an animal model of sepsis with different degree of organ injury, animals were treated with three different doses of lipopolysaccharide （4, 8 and 16 mg/kg）, and the animals in control group were treated with the same volume of the vehicle （saline）. The levels of serum HMGB1 were measured at 0, 2, 4, 8, 16, 24, 32 and 48 hours after lipopolysaccharide （LPS） or vehicle injection, meanwhile the biochemical and histopathological indicators for the severity of organ injury were assessed. Results The level of HMGB1 had a positive, high correlation with the abnormal changes of serum cardiac troponin I, alanine aminotransferase, aspartate aminotransferase, creatinine and blood urea nitrogen, as well as the pathologic scores of heart, lung, liver and kidney. Conclusions The level of serum HMGB1 is highly correlated with the severity of sepsis in rats, suggesting that HMGB1 could serve as a valuable adjunct in the diagnosis and management of sepsis.
