脂联素与慢性乙型肝炎病毒感染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结果进行对比,探讨脂联素与慢性乙型肝炎肝纤维化的相关性。方法采用酶联免疫法（ELISA）定量检测血清脂联素水平,免疫组织化学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HBV DNA变化,并对患者进行抗病毒治疗前后的纤维化程度进行比较。结果血清脂联素在肝纤维化的各个阶段均有表达且与肝纤维化的分级呈正相关（r=0.976,P〈0.01）,与转氨酶水平及HBV DNA浓度无相关性（P〉0.05）;血清脂联素与肝硬化呈独立相关（P=0.02,相对危险度为1.07,95%可信区间为1.00～1.14）。在抗病毒治疗后,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 of adiponectin and chronic hepatitis B associated liver fibrosis

Objective To explore the expression of adiponectin in the chronic hepatitis B patients and compare adiponectin expression before and after antiviral therapy.Methods Serum adiponectin was detected by ELISA,expression of adiponectin in liver tissue was detected by immunohistochemistry.The liver functions and HBV-DNA was also tested.Liver biopsy tissue was assessed by fibrosis stage.Results Serum adiponectin was detected in different fibrosis stage and associated with fibrosis stage,not with HBV-DNA and liver function(ALT).Serum adiponectin is independently associated with liver cirrhosis(P=0.02;relative risk:1.07;95% confidence interval 1.00～1.14).At the end of antiviral therapy,the expressions of adiponectin have declined in patients with improved fibrosis and sustained viral response.Conclusions Serum adiponecin may play a role in chronic hepatitis B fibosis,and the reduction of adiponectin level is associated with improved fibrosis after antiviral therapy.