慢性重型乙型肝炎患者血清Slit2蛋白的临床意义

目的探讨慢性重型乙型肝炎患者血清中Slit2蛋白水平,以及其与患者肝脏损伤程度、预后的关系。方法将某院感染病科2014年2—7月住院及门诊收治的病毒性肝炎慢性乙型(慢性肝炎组)患者、病毒性肝炎慢性重型乙型(慢性重型肝炎组)患者纳入研究,健康志愿者为正常对照组,慢性重型肝炎组患者根据病情恢复情况再细分为恢复组和未恢复组,比较血清中Slit2蛋白、凝血酶原活动度(PTA)、总胆红素(TBIL)、谷丙转氨酶(ALT)水平,并进行相关性分析。结果共纳入慢性乙型肝炎患者157例(其中慢性肝炎组93例、慢性重型肝炎组64例)和健康志愿者10例(健康对照组),3组之间Slit2蛋白水平比较,差异有统计学意义(F=5.596,P=0.004),慢性肝炎组和慢性重型肝炎组患者血清中Slit2蛋白分别为(4.90±1.07)ng/mL、(3.09±1.00)ng/mL,均高于健康对照组(2.10±0.60)ng/mL](均P0.05);慢性重型肝炎组患者血清Slit2蛋白水平低于慢性肝炎组(P0.05)。慢性重型肝炎未恢复组患者血清Slit2蛋白水平为(1.88±0.67)ng/mL,低于慢性重型肝炎恢复组(2.96±1.32)ng/mL],差异有统计学意义(t=2.319,P=0.032)。慢性乙型肝炎患者血清Slit2蛋白水平与PTA呈正相关(r=0.33,P0.05);与TBIL水平、ALT水平呈负相关(r值分别为-0.46、-0.32,均P0.05)。结论血清Slit2蛋白水平是反映慢性重型肝炎患者预后的重要指标,低水平Slit2预示着预后不佳。

Clinical significance of serum Slit2 protein in patients with chronic severe hepatitis B

ObjectiveTo evaluate serum Slit2 protein level in patients with chronic severe hepatitis B, and the relation with extent of liver damage and prognosis of patients.MethodsIn February July 2014, patients with chronic hepatitis B(chronic hepatitis group) and chronic severe hepatitis B(chronic severe hepatitis group) in an infectious department were observed, healthy volunteers were as control group, and patients in chronic severe hepatitis group were subdivided into recovery subgroup and non recovery subgroup based on whether patients had recovered. Serum Slit2 protein, prothrombin activity(PTA), total bilirubin (TBIL), and alanine transaminase（ALT）levels were detected and compared.ResultsA total of 157 patients (chronic hepatitis group, n=93; chronic severe hepatitis group, n=64) and 10 healthy volunteers were included in the study . Slit2 protein levels were significantly different among three groups（F=5.596，P=0.004）, serum Slit2 protein levels in chronic hepatitis group and chronic severe hepatitis group were (4.90±1.07) ng/mL and (3.09±1.00)ng/mL respectively, both were higher than (2.10±0.60)ng/mL in healthy control group (both P＜0.05); serum Slit2 protein level in chronic severe hepatitis group was significantly lower than chronic hepatitis group (P＜0.05). Serum Slit2 protein level in non recovery subgroup of chronic severe hepatitis group was significantly lower than recovery subgroup (［1.88±0.67］ ng/mL vs ［2.96±1.32］ng/mL, t=2.319,P=0.032). Serum Slit2 protein level in patients with chronic hepatitis B was positively correlated with PTA level(r=0.33，P＜0.05), but negatively correlated with serum TBIL level (r=-0.46，P＜0.05) and ALT level （r=-0.32，P＜0.05）.ConclusionSerum Slit2 protein level is an important index which can reflect the prognosis of patients with chronic severe hepatitis, low serum Slit2 level suggests the poor clinical prognosis.