慢性乙型肝炎肝组织损伤的相关因素研究

Objective To study the expression of adiponectin and α-smooth muscle actin (α-SMA) in liver from the patients of chronic hepatitis B(CHB) overlapped non-alcoholic fatty liver disease( NAFLD), and to explore the mechanism of CHB patients with NAFLD. Methods 94 patients of CHB overlapped NAFLD (case group)underwent liver biopsy, 119 cases of patients with CHB alone (control group) as control, the fasting venous blood sample was taken for liver biochemical and virological indicators. Liver biopsy specimens were immunohistochemically stained for histology, adiponectin and α-SMA, and integral absorbance. Results The serum ALT, total cholesterol, triglyceride, low density lipoprotein cholesterol and fasting glucose levels in case group were significantly higher than that in control group (Z = 3.425,4.488,4.858、2.265, P < 0.05) .There was no significant difference in HBV DNA viral load and HBeAg between the two groups( Z = 0.825, χ2 = 0.323, P > 0.05). In case group, adiponectin expression was no significant correlation with steatosis, inflammation and fibrosis(r = 0.032, -0.107, -0.133, P>0.05); however, in control group adiponectin was negatively related to inflammation and fibrosis(r= -0.223, -0.259,P<0.05). In case group,α-SMA expression was significant correlation with inflammation and fibrosis( r = 0.323,0.355, P < 0.05). In control group, its expression was no correlation with inflammation and fibrosis( r = 0.172,0.155, P > 0.05). Conclusions The occurrence of NAFLD is mainly related to metabolic factors and no relation with viral factors. Adiponectin is not directly related to liver injury of patients of CHB overlapped NAFLD. α-SMA may be important indicator of liver injury,and NAFLD may promote the progress of liver injury in patients with CHB.

Research of relative factors on liver injury in chronic hepatitis B