HBV相关慢加急性肝衰竭患者血清M30、M65检测及其临床意义

目的检测HBV相关慢加急性肝衰竭（ACLF）患者血清M30、M65的水平，探讨其与疾病的关系。方法选取31例HBV相关ACLF患者（好转20例，无效11例）; 20例慢性乙型肝炎（CHB）患者，10例健康人为对照，采用ELISA方法检测外周血清中M30、M65水平，多组间数据比较采用方差分析,两两比较采用q检验。结果ACLF组血清M30 ［（508.65±340.16）U/L］、M65［（76875±290.02）U/L］高于CHB组［（212.27±91.33）U/L，P＜0.05；（384.40±134.46）U/L，P＜0.05］和健康对照组［（94.12±17.64）U/L，P＜0.05；（121.99±29.25）U/L，P＜0.05］。ACLF患者血清M30与M65水平呈正相关（r=0.78，P＜0.05）。好转组与无效组血清M30、M65水平差异无统计学意义［（572.38±349.45） vs （436.14±285.59）U/L，P=0.29；（817.25±307.66） vs （703.90±221.37）U/L，P=0.31］。结论M30、M65水平能够较为准确的反映肝脏的细胞凋亡及坏死程度，在HBV相关ACLF患者中显著升高。

Determination of serum M30 and M65 levels and its clinical significance in patients with HBV - related acute - on - chronic liver failure

ObjectiveTo determine the serum M30 and M65 levels in patients with HBV-related acute-on-chronic liver failure （ACLF） and to investigate their association with this disease. MethodsThirty-one patients with HBV-related ACLF （20 cases with response to treatment and 11 cases without response to treatment）, 20 patients with chronic hepatitis B （CHB）, and 10 healthy controls were enrolled in the study. Serum M65 and M30 levels were measured by enzyme-linked immunosorbent assay. Analysis of variance was used for comparison among groups; q-test was used for pairwise comparison. ResultsThe serum M30 and M65 levels of ACLF patients （508.65±340.16 and 768.75±290.02 U/L） were significantly higher than those of CHB patients （212.27±91.33 and 384.40±134.46 U/L） and healthy controls （94.12±17.64 and 121.99±29.25 U/L） （P〈0.05 for all comparisons）. In the ACLF patients, the serum level of M30 was positively correlated with that of M65 （r=0.78, P〈0.05）; no significant differences were seen between the cases with response to treatment and those without response to treatment in serum M30 and M65 levels （572.38±349.45 vs 436.14±285.59 U/L, P=0.29; 81725±307.66 vs 703.90±221.37 U/L, P=0.31）. ConclusionSerum levels of M30 and M65 are sensitive indicators for the necrosis and apoptosis of hepatocytes. Significant increases in serum M30 and M65 levels are observed in patients with HBV-related ACLF.