脂联素与慢性乙型肝炎肝纤维化的关系研究

目的研究脂联素在慢性乙型肝炎病毒感染患者中的表达，并对部分患者抗病毒治疗前后的脂联素水平进行对比，探讨脂联素与慢性乙型肝炎肝纤维化的相关性。方法ELISA法定量检测血清脂联素水平，免疫组织化学法以及RT-PCR法检测肝活检组织脂联素的表达，同时检测患者肝功能以及HBVDNA变化，并对患者肝脏穿刺前后的纤维化程度进行比较。结果血清脂联素水平在慢性乙型肝炎肝硬化患者中的表达（20．65±1．29）mg／L]高于肝纤维化0～1级、2级以及3级的患者分别为（8．57±0．28）、（12．22±0．64）、（15．22±0．77）mg／L]，P〈0．01。血清脂联素水平与肝纤维化分级呈正相关（r=0．976，P〈0．01），与血清转氨酶水平及血清HBVDNA滴度无关（P〉0．05）；血清脂联素水平与肝硬化呈独立相关（相对危险度为1．07，95％可信区间为1．00～1．14。P=0．02）。在抗病毒治疗后，患者肝纤维化程度改善以及获得持续病毒学应答的患者血清脂联素水平降低。结论血清脂联素在慢性乙型肝炎肝纤维化的进展过程中发挥了作用，血清脂联素水平在抗病毒治疗后显著下降，并与肝纤维化改善有关。

Study on the connection between adiponectin and chronic hepatitis B associated with liver fibrosis

Objective To explore the adiponectin expression in the chronic hepatitis B （CHB） patients and compare the level of adiponectin before and after antiviral therapy, and investigate the relationship between adiponectin and CHB. Methods Serum adiponectin was detected by enzyme linked immunosorbent assay （ELISA）, and the expression of adiponectin in liver tissue was detected by polymerase chain reaction （PCR） and immunohistochemistry. The liver functions and HBV DNA were also tested. Liver biopsy tissue was assessed by fibrosis stage. Results Serum adiponeetin in CHB liver cirrhosis （20.65 ± 1.29） mg/L ] was higher than that in other stage fibrosis, the values were （8.57±0.28 ）, （12.22 ± 0.64）, （15.22± 0.77 ） mg/L （P 〈 0.01 ）. Serum adiponectin was positively associated with fibrosis stage（r = 0.976, P 〈 0.01 ）. There was no significant difference between HBV DNA and ALT （P 〉 0.05 ）. Serum adiponectin was independently associated with liver cirrhosis （r = 1.07, P = 0.02, 95% CI = 1.00-1.14）.At the end of antiviral therapy,the expressions of adiponectin declined in patients with improved fibrosis and sustained viral response. Conclusion Serum adiponeetin may play a role in CHB fibrosis, and reduced adiponectin level is associated with improved fibrosis after antiviral therapy.