乙型肝炎患者肝组织中Bcl-2、Bax、Bak的表达及意义

目的研究Ｂｃｌ－２、Ｂａｘ、Ｂａｋ蛋白在乙型肝炎（乙肝）肝细胞凋亡及坏死中的作用。方法用免疫组织化学法、原位未端标记技术（ＴＵＮＥＬ）检测８９例各型乙肝患者肝组织Ｂｃｌ－２、Ｂａｘ、Ｂａｋ表达和肝细胞凋亡的情况。结果肝硬化组（１０例）、急性肝炎组（８例）、慢性肝炎组（５５例）和重型肝炎组（１６例）的ＴＵＮＥＬ实验中度以上阳性率分别为３０．０％,２５．０％,６１．８％和９３８％;Ｂｃｌ－２蛋白表达中度以上阳性率分别为３０．０％,２５．０％,３８．２％和１２．５％;Ｂａｘ表达中度以上阳性率分别为２０．０％,２５．０％,４７．３％和８７．５％;Ｂａｋ表达中度以上阳性率分别为１０．０％,１２．５％,２５．５％和７５．０％。ＴＵＮＥＬ反应及Ｂａｘ、ＢａＫ表达阳性程度在各型乙型肝炎中的分布差异均有显著性（Ｐ＜０．０５）,两蛋白的阳性程度随坏死程度的增加而增强。Ｂｃｌ－２在增生区的表达显著高于坏死区。结论Ｂａｘ、Ｂａｋ的加强表达有促进肝细胞死亡的作用,两者的表达水平可反映肝组织损伤和炎症活动程度。

Expressions of Bcl-2, Bax and Bak proteins in liver tissues of hepatitis B patients and their significance

Objective To investigate the expressions of Bcl-2, Bax and Bak proteins in liver tissuesof hepatitis B patients and their relations to apoptosis and necrosis of hepatocytes. Methods TUNEL assayand immunohistochemistry were uest to daest hepatic apoptosis, Bcl-2, Bax and Bak proteins expressionson hepatocytes respectively. Besults in liver cirrhosis group(10 cases), acute hepatitis group(8 cases),chronic hepatitis group (55 cases) and hepatic failure group(16 cases), the moderate positive rates ofTUNEL assay were 30.0%, 25.0%, 61.8% and 93.8% respectively; the moderate positive rates of Bcl-2oncoprotein were 30.0%, 25.0%, 38.2% and 12.5% resistively; the morderate positive rates of Bax proteinwere 20.0%, 25.0%, 47.3% and 87.5% resistively; the morderate positiye rates of Bak protein were 10.0%,12.5%. 25.5% and 75.0% respeCtively. There was a positive correlation between de~s of the expression ofBax, Bak and hepatic apoptosis (P<0.05). The expression of Bcl-2 protein on hepatocytes in proliferationzones was stronger than in necrosis zones. Conclusions The enhanced degrees of the expression of Baxand Bak proteins were accompanied with the enhanced degrees of the necrosis.