脂多糖在慢性乙型肝炎肝内血管病变中的作用

目的探讨LPS在慢性乙型肝炎肝内血管病变中的作用。方法将120例慢性乙型肝炎患者按肝内血管病变级别分为1、2、3级3组,另设10例大致正常肝组织作为对照组。采用ELISA法定量检测血清LPS水平。采用免疫组化染色法检测肝组织TLR4的表达,采用综合评分法判断结果。结果①健康对照组血清LPS水平较低(0.30±0.13ng/ml)。肝内血管病变1级组血清LPS水平为0.32±0.14ng/ml,与正常对照组比较无明显差异(P>0.05)。而肝内血管病变2级、3级组血清LPS水平分别为0.71±0.14ng/ml,1.10±0.15ng/ml,明显高于正常对照组(P<0.01)。慢性乙型肝炎患者血清LPS水平与肝内血管病变严重程度呈正相关(r=0.892,P<0.01)。②不同肝内血管病变级别的慢性乙型肝炎肝组织TLR4阳性表达与对照组比较均有差异(P<0.05)。TLR4主要表达在胞膜上及部分胞浆内,细胞核无表达。TLR4在慢性乙型肝炎肝组织的表达强度与肝内血管病变分级呈正相关(r=0.728,P<0.01)。结论 LPS及其受体TLR4在慢性乙型肝炎肝内血管病变中起着重要作用。血清LPS水平可作为判断肝内血管病变程度的指标之一。

The effect of lipopolysaccharides on hepatic vascular pathologic changes in chronic hepatitis B

Objective The aim of this study is to explore the effect of lipopolysaccharides on hepatic vascular pathologic changes in chronic hepatitis B.Methods 120 cases of patients with chronic hepatitis B were classified by hepatic vascular pathologic changes.Normal liver tissue of 10 healthy persons were chosen as the control group.The serum LPS levels in cases were quantitatively determinated with enzyme linked immunosorbent assay(ELISA).The expression of TLR4 was determined by immunohistochemical staining.The results were evaluated by integrative index.Result ①The serum LPS levels in healthy controls were very low(0.30±0.13ng/ml).The serum LPS levels of patients with hepatic vascular lesions grade 1 were 0.32±0.14ng/ml.There was no signifiant difference in the serum levels between patients of hepatic vascular lesions grade 1 and normal controls(P>0.05).The serum LPS levels of patients with hepatic vascular lesions grade 2 and grade 3 were 0.71±0.14ng/ml and 1.10±0.15ng/ml respectivity,which were significantly higher than those of normal controls(P<0.01).There was a positive correlation between serum LPS level and the grade of hepatic vascular lesions(r=0.892,P<0.01).②The intensity of TLR4 expression in liver tissue of chronic hepatitis B was significantly higher than that of health control(P<0.05).The positive staining was mainly located on cell membrane and some in cytoplasm.In chronic hepatitis B,the intensities of TLR4 were positively correlated with the grade of hepatic vascular lesions(r=0.728,P<0.01).Conclusions LPS and its receptor TLR4 might play an important role in hepatic vascular pathologic changes.The serum LPS level can be used as one of indexes to predict the severity of hepatic vascular lesions.