HBV感染者血清载脂蛋白E的检测及临床意义探讨

目的：探讨血清载脂蛋白E（ApoE）在不同病情HBV感染患者中的表达水平及其临床意义。方法：收集40例健康献血员以及57例慢性乙型病毒性肝炎（CHB）、55例乙肝肝硬化（LC）及50例原发性肝癌（HCC-HBSAg阳性）患者血清，检测载脂蛋白E（ApoE）、总胆固醇（TCHO）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL～C）、载脂蛋白A1（ApoAl）、载脂蛋白B（ApoB）及肝功能指标，并对检测结果进行统计学分析，．结果：疾病组（包括CHB、LC、HCC）血清ApoE含量均显著高于正常对照组（均P〈0．05），随着疾病的进展ApoE含量逐渐升高，但组问差异不大（均P〉0．05）；而疾病组的其它血脂指标（TCHO、HDL—C、LDL—C、ApoAl、ApoB）均低于正常对照组。血清APOE与多个指标相关，特别是与1-谷氨酰基转移酶（GGT）和亮氨酰氨基肤酶（LAP）的相关性较高（均r〉0．30，均P〈0．01）。高GGT值（大于100U／L）组血清APOE水平显著高于低GGT值（小于100U／L）组（t=-4．926，P=0．000）。高HBV载量（大于10。IU／mL）组血清APOE水平显著高于低HBV载量（小于10^3IU／mL）组（t=-2．239，P=0．026）。结论：血清ApoE在不同病情HBV感染患者中的水平普遍升高，其表达可能受肝脏合成功能、淤胆因素以及HBV等多种因素的影响。

Detection and Clinical Significant of Apolipoprotein E in Patients Infected with HBV

Objective：To study the clinical implication of Apolipoprotein （Apo） E in patients infected with HBV. Methods ：Serum ApoE, Tcho, HDL- C ,LDL- C ,ApoA1, ApoB and other liver function indicators were measured in pa- tients with chronic hepatitis B （ CHB）, hepatitis B cirrhosis （ LC）, HCC （ HBSAg positive） and healthy individuals, and the results were statistically analyzed. Results： The serum ApoE levels were much higher in patients （including CHB, LC, HCC） as compared to healthy individuals （P 〈 0.05 ）. The serum ApoE levels were gradually increased with the dis- ease progression, but the difference within groups had no statistical significance（ all P 〉 0.05）. At the meanwhile, the other blood lipid indices were lower in patients as compared to healthy individuals. There was some correlation between the serum ApoE and some indicators, especially GGT and LAP（ all correlation coefficient more than 0.30, all P 〈 0.01 ）. The serum ApoE in patients with high GGT concentration（ 〉 100 U/L ）was significantly higher than those with low GGT concentration（ 〈 100 U/L ） （ t = - 4. 926, P = 0.000）. And the serum ApoE in patients with high HBV - DNA load （ 〉 1000 IU/mL ）was significantly higher than those with low HBV - DNA load （ 〈 1000 IU/mL） （t = -2. 239, P = 0.026）. Conclusions： The serum ApoE generally increases in patients infected with HBV,its expression is associated with hepatic function, intrahepatic cholestasis and HBV- DNA.