肝组织与血清转化生长因子β1表达水平与病毒性肝炎患者肝纤维化的关系

目的 观察肝纤维化不同阶段转化生长因子β_1(TGF β_1)在肝组织内表达情况及血清水平,探讨TGF β_1与肝纤维化发生发展的关系,评价肝脏、血清TGF β_1及血清Ⅲ型胶原(PC Ⅲ)、透明质酸(HA)、层黏连蛋白(LN)、Ⅳ型胶原(C Ⅳ)反映肝纤维化情况。 方法 随机选取92例慢性病毒性肝炎患者,酶联免疫法检测TGF β_1血清水平,其中31例行肝组织活检,做TGF β_1的免疫组织化学染色和胶原纤维染色,并用多媒体彩色图文分析系统对肝脏TGF β_1和胶原进行图像分析定量。 结果 (1)按肝组织纤维化程度(S)分组,除S_2组与S_1组比较外,TGF β_1随纤维化分期加重而表达增加,F=13.46,P<0.05。按炎症活动度级别(G)分组,G_1组、G_2组、G_3组、G_4组之间两两比较差异无显著性。(2)肝组织TGF β_1水平与血清TGF β_1浓度呈正相关(r=0.896)。肝组织TGF β_1水平与肝组织胶原含量呈正相关(r=0.863),肝组织TGF β_1水平与血清PC Ⅲ、HA、LN、C Ⅳ之间均呈正相关,r分别为0.824、0.720、0.747、0.839。 结论 肝脏和血清TGFβ_1表达水平与肝组织纤维化程度密切相关,且较HA、LN、C Ⅳ三项常规指标在反映早期纤维化方面更敏感。

The relationship between hepatic expression, serum level of TGFβ1 and the hepatic fibrosis in patients with viral hepatitis

OBJECTIVE: To detect the hepatic tissue and serum level of TGFbeta1 in patients with viral hepatitis, in order to clarify their relationship of the starting, developing of hepatic fibrosis. METHODS: This study included 92 patients with viral hepatitis. Liver puncture was performed in 31 patients. Hepatic collagen staining (Masson's three colors) and TGFbeta1 immunohistochemistry staining of the liver tissue specimens were performed, morphometric quantitative measurements of hepatic histological collagen and TGFbeta1 were made. The serum level of TGFFbeta1 was detected by ELISA. RESULTS: The surface density of hepatic TGFbeta1 increased linearly with the elevation of fibrosis stage (P < 0.05), there were no significant differences between every two groups of G1, G2, G3 and G4 (P > 0.005). There was a closely positive correlation between the levels of TGFbeta1 in hepatic tissue and serum, the coefficient was 0.896 (P < 0.01). The levels of TGFbeta1 in tissue and serum both had positive correlation with hepatic collagen, coefficients were 0.863 and 0.667 (P < 0.001). The level of TGFbeta1 in tissue and serum both had positive correlation with serum levels of PCIII, HA, LN, CIV (P < 0.001). CONCLUSIONS: There was a closely relationship between the levels of TGFbeta1 in hepatic tissue and serum and liver fibrosis. The detection of TGFbeta1 in liver and serum are more sensitive than HA, LN, CIV in early period of hepatic fibrosis.