乙肝病毒相关性慢性肝病患者血清GP73表达水平及其临床意义研究

发布时间：2018-06-16 08:28

本文选题：高尔基体蛋白73 + 乙型肝炎病毒　；参考：《重庆医科大学》2013年硕士论文

【摘要】：目的：探讨血清高尔基体蛋白73（Golgi Protein73, GP73）在慢性乙型肝炎病毒(Hepatitis B virus，HBV)感染所致的不同类型的慢性肝病患者血清中的表达水平及其临床意义。方法：收集177份各类HBV相关性慢性肝病患者血清与45份健康对照组血清，其中包括17例HBV携带者、70慢性乙型肝炎（chronichepatits B, CHB)、57例肝硬化(liver cirrhosis, LC)、33例肝细胞癌(hepatocellular carcinoma, HCC)患者。分别采用酶联免疫吸附法(enzyme-linked immunosorbent assay, ELISA)对血清GP73进行定量检测，生化分析仪检测ALB、TB、DB、ALT、AST、ALP、GGT的含量，电化学发光法测定AFP，化学发光法检测HA、LN、PIIINP、CIV，实时荧光定量PCR检测HBV DNA，全自动凝血分析仪测定PT、PTA。采用SPSS17.0统计软件进行统计学分析；运用Spearman相关性分析法分析GP73与其他检测指标间的相关性。结果：1.各组血清GP73表达水平由高到低分别为：HCC组1561.741±11.912ng/L，，CHB组700.756±19.337ng/L，LC组675.294±32.761ng/L，均显著高于健康对照组（558.853±5.883ng/L）或HBV携带者组（563.803±11.197ng/L）(P值均＜0.01)；HBV携带者组与健康对照组间无显著性差异（P=0.646）。 2. CHB各亚组血清GP73表达水平由高到低为：中度CHB亚组716.178±19.127ng/L，重度CHB亚组704.632±15.389ng/L，均显著高于轻度CHB亚组（688.751±10.114ng/L）(P值均＜0.01)；而中度CHB亚组与重度CHB亚组间无显著性差异（P=0.104）。CHB患者血清中HBV DNA载量与GP73水平呈正相关（r=0.438，P＜0.001）。 3.肝硬化代偿期亚组患者血清GP73水平（702.406±16.178ng/L)较失代偿期亚组(661.738±30.511ng/L)显著高(P=0.02)。 4. AFP阴性HCC亚组患者血清GP73水平(1562.550±13.964ng/L)较AFP阳性HCC亚组(1561.070±10.269ng/L)无显著性差异（P=0.727）。 5.将各不同病程患者血清GP73与肝功能、凝血功能、AFP、肝纤维谱及HBV DNA定量等指标进行Spearman相关分析，结果显示：在HBV携带者组GP73与ALB呈负相关（r=-0.946，P＜0.01）；在CHB组GP73与ALB、PTA呈负相关（r=-0.816，-0.430，P均＜0.01），与TB、DB、ALT、AST、ALP、GGT、PT、HA、PIIINP、CIV、lgDNA等指标呈正相关(r=0.609,0.633,0.330,0.373,0.321,0.441,0.468,0.423,0.278,0.274,0.438,P均＜0.05)；在LC组GP73与ALP、GGT、PT、HA、CIV呈正相关（r=0.368,0.382,0.382,0.330,0.383，P均＜0.05）；在HCC组GP73与ALB呈负相关（r=-0.858,P＜0.01），与TB、DB、ALT、AST、AFP、lgDNA呈正相关（r=0.936,0.945,0.693,0.456,0.250,0.434，P均＜0.05）。结论：1.首次探讨了慢性HBV感染所致CHB、LC、HCC、HBV携带者各组间、各亚组间患者血清GP73表达水平差异性。 2. CHB、LC患者血清GP73高水平表达提示肝脏健存肝细胞的功能、结构损伤较重，肝纤维化程度亦较重。 3.慢性HBV感染者血清GP73高水平表达还与HBV DNA载量增高及其导致肝细胞免疫学损伤加重相关。 4.在HCC患者，血清GP73高水平表达可作为AFP阴性者的诊断指标。
[Abstract]:Objective: To investigate the expression level and clinical significance of serum Golgi Protein73 (Golgi Protein73, GP73) in the serum of chronic hepatitis B patients with chronic hepatitis B virus (Hepatitis B virus, HBV) infection.
Methods: the serum of 177 patients with HBV related chronic liver disease and 45 healthy controls were collected, including 17 HBV carriers, 70 chronic hepatitis B (chronichepatits B, CHB), 57 cirrhosis (liver cirrhosis, LC), 33 cases of hepatocellular carcinoma (hepatocellular carcinoma, HCC). The enzyme linked immunosorbent assay (enzyme) was used respectively. -linked immunosorbent assay, ELISA) the quantitative detection of serum GP73, biochemical analyzer to detect ALB, TB, DB, ALT, AST, ALP, GGT content, electrochemiluminescence detection, real-time fluorescence quantitative detection, statistical software for statistics Spearman correlation analysis was used to analyze the correlation between GP73 and other test indexes.
Results: 1. the levels of serum GP73 expression from high to low were 1561.741 + 11.912ng/L, 700.756 + 19.337ng/L in group CHB and 675.294 + 32.761ng/L in group LC, which were significantly higher than those in the healthy control group (558.853 + 5.883ng/L) or HBV carrier group (563.803 + 11.197ng/L) (P < 0.01). There was no significant difference between the HBV carrier group and the healthy control group. Differences (P=0.646).
The levels of serum GP73 expression in 2. CHB subgroups were from high to low: moderate CHB subgroup 716.178 + 19.127ng/L, severe CHB subgroup 704.632 + 15.389ng/L, which were significantly higher than those in mild CHB subgroup (688.751 + 10.114ng/L) (P < 0.01), but there was no significant difference between the moderate CHB subgroup and the severe CHB subgroup (P=0.104) There was a positive correlation between the 3 levels (r=0.438, P < 0.001).
3. the level of serum GP73 (702.406 + 16.178ng/L) in compensatory subgroup of liver cirrhosis was significantly higher than that in decompensated subgroup (661.738 + 30.511ng/L) (P=0.02).
There was no significant difference in serum GP73 level (1562.550 + 13.964ng/L) between 4. AFP negative HCC subgroup and AFP positive HCC subgroup (1561.070 + 10.269ng/L) (P=0.727).
5. the serum GP73 of patients with different course of disease and liver function, coagulation function, AFP, liver fiber spectrum and HBV DNA were analyzed by Spearman. The results showed that the GP73 in the HBV carrier group was negatively correlated with ALB (r=-0.946, P < 0.01). HA, PIIINP, CIV, lgDNA are positively correlated (r=0.609,0.633,0.330,0.373,0.321,0.441,0.468,0.423,0.278,0.274,0.438, P < 0.05), and GP73 in LC group is positively correlated with ALP, GGT, PT, HA. Positive correlation (r=0.936,0.945,0.693,0.456,0.250,0.434, P < 0.05).
Conclusion: 1.. For the first time, the difference of serum GP73 expression among CHB, LC, HCC, HBV carriers in different groups of patients with chronic HBV infection was discussed.
2. the high level of serum GP73 expression in patients with CHB and LC suggests that the liver has the function of protecting the liver cells, the structural damage is heavier, and the degree of liver fibrosis is heavier.
3. the high level of serum GP73 expression in chronic HBV infection is also related to the increase of HBV DNA load and the aggravation of liver cell immune injury.
4. in patients with HCC, the high level of serum GP73 expression can be used as a diagnostic marker for AFP negative patients.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R512.62

【参考文献】