sICAM-1在乙肝发病中的作用及与α干扰素抗病毒治疗应答关系的初步研究

发布时间：2018-06-29 14:09

  本文选题：细胞间粘附分子-1 + 乙肝相关性肝病　； 参考：《重庆医科大学》2013年硕士论文

【摘要】：第一部分sICAM-1在乙肝相关性肝病发病中作用的初步研究 目的：通过检测乙肝相关性肝病患者血清可溶性细胞间粘附分子-1（Soluble intercellular adhesion molecule-1，sICAM-1）的水平，探讨sICAM-1在乙肝相关性肝病发病中的作用。 方法：选择慢性乙型肝炎、乙型肝炎肝硬化及肝衰竭患者各30例，另选择健康献血员30例作对照组，应用酶联免疫吸附法（Enzyme-1inked immunosorbent assay，ELISA）检测血清sICAM-1的水平。 结果：慢性乙型肝炎、乙型肝炎肝硬化、肝衰竭患者血清sICAM-1水平较正常对照组均明显升高(P=0.029，P=0.00007，P=0.0001)，并与丙氨酸氨基转移酶(Alanine aminotransferase，ALT)、天门冬氨酸氨基转移酶(Aspartate aminotransferase，AST)及总胆红素(Total bilirubin，TBIL)呈正相关（ALT：r=0.240，P=0.023；AST：r=0.225，P=0.033；TBIL：r=0.262，P=0.013），与白蛋白（Albumin，ALB）、凝血酶原活动度（Prothrombin activity，PTA）呈负相关（ALB：r=-0.297，P=0.005；PTA: r=-0.218，P=0.039）。 结论：sICAM-1可能参与了乙型肝炎免疫损伤过程，并可能在肝纤维化、肝硬化形成过程中发挥重要作用。检测乙肝相关性肝病患者血清sICAM-1水平对判断患者病情有一定临床意义。 第二部分粘附分子与聚乙二醇干扰素-α-2a抗乙肝病毒治疗应答关系的初步研究 目的：探讨血清可溶性细胞间粘附分子-1（Soluble intercellularadhesion molecule-1， sICAM-1）、血管细胞粘附分子-1(Solublevascuolar cell adhesion molecule-1，sVCAM-1)、E-选择素（SolubleE-selectin，sE-selectin）、L-选择素（Soluble L-selectin，sL-selectin）等粘附分子水平与聚乙二醇干扰素-α-2a (Pegylated interferonalpha-2a,PegIFN-α-2a)治疗慢性乙型病毒性肝炎（Chronic hepatitis B，CHB）病毒学应答的关系。 方法：纳入32例CHB患者（基因型检测均为B型），均接受PegIFN-α-2a180μg每周1次治疗，于首次PegIFN-α-2a治疗前及治疗后12周、24周采血。另选择健康献血员30例作对照组，采用酶联免疫吸附法（Enzyme-1inked immunosorbent assay，ELISA）检测血清sICAM-1、sVCAM-1、sE-selectin、sL-selectin。 结果：CHB患者治疗前sICAM-1、sVCAM-1、sE-selectin、sL-selectin水平明显高于对照组（p均0.00001）；PegIFN-α-2a治疗应答组患者治疗前sICAM-1、sVCAM-1、sE-selectin、sL-selectin水平明显高于无应答组患者（PI=0.001，PV=0.002，PE=0.02，PL=0.004），治疗后各阶段血清sICAM-1、sVCAM-1、sE-selectin、sL-selectin水平均明显下降PI=0.0001，PV=0.00004，PE=0.002，，PL=0.0004；PI=0.00007，PV=0.00001，PE=0.0003，PL=0.00003；而无应答组治疗前后血清sICAM-1、sVCAM-1、sE-selectin、sL-selectin水平比较差异无显著性（P均0.05）。 结论：sICAM-1、sVCAM-1、sE-selectin、sL-selectin可能作为预测PegIFN-α-2a治疗CHB患者疗效的有效指标。
[Abstract]:Part I the role of sICAM-1 in the pathogenesis of hepatitis B associated liver disease objective: to detect the level of soluble intercellular adhesion molecule-1 (sICAM-1) in serum of patients with hepatitis B associated liver disease. To investigate the role of sICAM-1 in the pathogenesis of hepatitis B related liver disease. Methods: 30 patients with chronic hepatitis B, 30 patients with cirrhosis of hepatitis B and 30 patients with liver failure were selected as control group. The serum levels of sICAM-1 were detected by Enzyme-1inked immunosorbent assay-linked immunosorbent assay (Elisa). Results: chronic hepatitis B, hepatitis B cirrhosis, The serum levels of sICAM-1 in patients with liver failure were significantly higher than those in the control group (P0.029 / P0.00007 / P0. 0001), and were positively correlated with Alanine aminotransferase (alt), Aspartate aminotransferase (AST) and total bilirubin (TBIL). There was a negative correlation between TBI: r ~ (0.262) and Albumin (ALB) and prothrombin activity (PTA) (ALB: r ~ (-0.297) P _ (0.005) P _ (TAA): r ~ (-0.218N) P _ (0.039). ConclusionsICAM-1 may be involved in the process of hepatitis B immune injury, and may play an important role in the process of liver fibrosis and cirrhosis. Detection of serum sICAM-1 level in patients with hepatitis B-associated liver disease has certain clinical significance. Part two the relationship between adhesion molecules and the antiviral response of polyethylene glycol interferon-伪-2a objective: to investigate the relationship between serum soluble intercellularadhesion molecule-1 (sICAM-1) and vascular cell adhesion molecule 1 (Soluble cell adhesion molecule cell adhesion) The relationship between the levels of adhesion molecules such as Soluble L-selectin (Soluble L-selectin) and Pegylated interferon- 伪 -2a (PegIFN- 伪 -2a) in the treatment of chronic viral hepatitis B (CHB). Methods: 32 CHB patients (genotype B) were treated with PegIFN- 伪 -2a 180 渭 g once a week. Blood samples were collected before and after the first treatment of PegIFN- 伪 -2a. 30 healthy blood donors were selected as control group. The serum sICAM-1sVCAM-1 and sE-selectinsL-selectinin were detected by Enzyme-1inked immunosorbent Assay Elisa. 缁撴灉锛欳HB鎮ｈ

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