肝纤维化TGF-β1、CTGF mRNA表达与超声诊断相关性研究

发布时间：2018-01-01 22:28

本文关键词：肝纤维化TGF-β1、CTGF mRNA表达与超声诊断相关性研究　出处：《皖南医学院》2015年硕士论文　论文类型：学位论文

【摘要】：目的:研究乙型肝炎病毒感染的肝纤维患者超声显像肝实质回声及肝叶形态改变,探讨肝纤维化改变过程中,结缔组织生长因子(CTGF)与转化生长因子β1(TGF-β1)的表达。方法:本研究主要选取40例乙型肝炎病毒感染的患者,并通过超声引导下的肝组织穿刺及病理活检,确诊为肝纤维化的。另随机选取10例体检中心提供的近期及目前未检测出乙肝病毒携带的健康者作对照。根据病理结果,乙型肝炎病毒感染患者的肝组织分为4个级别,分别是1)小叶内局限性纤维化,设为II组;2)汇管区周围性纤维化,形成纤维间隔设为III组;3)S3,大量纤维间隔的形成,伴假小叶的形成,设为IV组;4)S4,早期肝硬化,设为V组。记录各检查组例数,10例健康检查者设为I组。再分别测量所有检查者肝脏主要径线。利用荧光实时定量RT-PCR方法,测定检查者外周血有核细胞中TGF-β1及CTGF mRNA含量。结果:(1)二维超声及多普勒频谱测定肝脏的主要径线与肝纤维化的严重程度呈正相关性,其数值变化有统计学差异。(2)检查者的性别及年龄因素对人体内TGF-β1及CTGF mRNA的表达水平的影响无明显统计学差异(P=0.060,P=0.105),但感染乙型肝炎病毒并引起肝纤维化形成的病程与TGF-β1及CTGF mRNA的表达有统计学差异(P=0.021)。(3)乙型肝炎病毒感染的实验组的TGF-β1及CTGF mRNA的表达明显高于正常对照组(0.091±0.024 VS 0.055±0.003,P=2.17E-5;0.0724±0.0232 VS0.0383±0.003,P=3.10E-5);在乙型肝炎病毒感染的实验组中,各组间TGF-β1及CTGF mRNA的表达分别为:S1级(0.069±0.0369、0.0546±0.003)、S2级(0.0899±0.002、0.0681±0.002)、S3(0.0975±0.001、0.0759±0.001)及S4(0.1444±0.014、0.1276±0.0121),差异具有显著统计学意义(P=0.000)。结论:1.对肝纤维化患者检查可见:肝右叶斜径大小的变化,门静脉内径增宽的程度及其流速改变,肝动脉峰值流速及阻力指数的变化以及脾脏大小的改变,均一定程度上反映了肝纤维严重程度。但其主要反应肝纤维化晚期及肝硬化失代偿期的变化,早期诊断肝纤维化敏感性不高。2.TGF-β1及CTGF mRNA在人体内的表达水平,与感染乙肝病毒后形成肝纤维化的病程长短有一定的相关性,而与患者的年龄、性别无明显的相关性。3.乙型肝炎病毒感染的患者体内TGF-β1及CTGF mRNA的表达水平高于对照的健康体检组。在实验组内,TGF-β1及CTGF mRNA的表达水平均随纤维化严重程度的升高而增加。表明肝脏TGF-β1和CTGF表达水平与肝组织纤维化呈较为明显的相关性。
[Abstract]:Objective: to study the changes of hepatic parenchyma echo and liver lobe morphology in patients with hepatitis B virus infection by ultrasonography, and to explore the process of hepatic fibrosis. Expression of connective tissue growth factor CTGF- 尾 1 and transforming growth factor 尾 1 TGF- 尾 1. Methods: 40 patients with hepatitis B virus infection were selected in this study. The liver biopsy and biopsy were conducted under the guidance of ultrasound. The liver fibrosis was diagnosed. Another 10 healthy persons provided by the physical examination center were randomly selected as the control group, which were not detected the hepatitis B virus carrier at present. According to the pathological results, 10 healthy persons with hepatitis B virus were selected as the control group. The liver tissues of patients with hepatitis B virus infection were divided into 4 grades: 1) localized fibrosis in the lobules, divided into group II; 2) Peripheral fibrosis in the catchment area, and the formation of fibrous septum was divided into III group; (3) S3, the formation of a large number of fibrous intervals, with pseudolobules, was divided into group IV; 4S4, early cirrhosis, set up as group V, and recorded the cases of each inspection group. Ten health examiners were divided into group I. the main hepatic lines of all the examiners were measured respectively. Fluorescence real-time quantitative RT-PCR method was used. The contents of TGF- 尾 1 and CTGF mRNA in peripheral blood nucleated cells were determined. The main diameter of liver was positively correlated with the severity of hepatic fibrosis. There was no significant difference in the expression of TGF- 尾 1 and CTGF mRNA between sex and age (P < 0.05). P0. 060. (P = 0.105). However, the course of hepatitis B virus infection and hepatic fibrosis was significantly different from the expression of TGF- 尾 1 and CTGF mRNA. The expression of TGF- 尾 1 and CTGF mRNA in the experimental group with hepatitis B virus infection was significantly higher than that in the control group (0.091 卤0.024 vs 0.055 卤0.003). 2. 17E-5; 0.0724 卤0.0232 VS0.0383 卤0.003 Pe 3.10E-5; In the experimental group infected with hepatitis B virus, the expression of TGF- 尾 1 and CTGF mRNA in each group were 0.069 卤0.0369 respectively. 0.0546 卤0.003 S3 + 0.0899 卤0.002P0. 0681 卤0. 002 S3 + 0. 0975 卤0. 001. 0.0759 卤0.001) and 0.1444 卤0.01444 卤0.01476 卤0.0121). The difference was statistically significant (P < 0. 000). Conclusion 1. The changes of the oblique diameter of the right lobe of the liver, the width of the portal vein and the change of the velocity of the portal vein can be seen in the patients with hepatic fibrosis. The changes of peak flow velocity and resistance index of hepatic artery and the size of spleen reflect the severity of hepatic fiber to some extent, but they mainly reflect the changes of hepatic fibrosis and decompensation of liver cirrhosis. The expression level of TGF- 尾 1 and CTGF mRNA in human body was correlated with the course of liver fibrosis after hepatitis B virus infection. With the patient's age. The expression levels of TGF- 尾 1 and CTGF mRNA in patients with hepatitis B virus infection were higher than those in healthy controls. TGF- 尾 1 and CTGF. The expression of mRNA increased with the severity of fibrosis, indicating that the expression of TGF- 尾 1 and CTGF was significantly correlated with hepatic fibrosis.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R575.2;R445.1

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