血清高迁移率族蛋白-1在不同慢性乙肝相关性肝病患者的含量变化及临床意义

目的 研究晚期炎症介质高迁移率族蛋白-1（HMGB1）在慢性乙型肝炎、慢性重型乙型肝炎及乙肝肝硬化病程中的临床意义.方法 选择慢性乙型肝炎患者40例,慢性重型乙型肝炎患者18例,乙肝肝硬化患者18例,健康对照者20例,应用ELISA法检测血清HMGB1含量;同时检测各组患者肝功能生化指标、凝血酶原活动度（PTA）及肝纤维化指标.结果 HMGB1检出含量在乙型肝炎患者慢性重型肝炎组高于慢性肝炎组（P＜0.01）,慢性肝炎组高于正常对照组（P＜0.01）,肝硬化组与慢性重型肝炎组、慢性肝炎组之间差异有统计学意义（P＜0.01）.HMGB1检出含量与外周血TBIL、AST/ALT、HA及PⅢNP均呈正相关（r=0.865,0.646,0.783,0.662,P＜0.01）,与PTA及白蛋白水平呈负相关（r=-0.915,-0.852,P＜0.01）.结论 乙肝相关性肝病患者血清HMGB1含量与其疾病严重程度密切相关,同时HMGB1也是辅助诊断肝纤维化的指标.

Diversity of serum levels of high mobility group box-1 in patients with hepatitis B and its clinical significance

Objective To investigate the clinical significance of high mobility group box-1 protein (HMGB1) in chronic,severe hepatitis B patients and liver cirrhosis.Methods The contents of HMGB1 was measured by enzyme-linked immunoassay (ELISA) in the patients (include 40 patients with chronic hepatitis B and 18 severe hepatitis B patients and 18 liver cirrhosis patients) and 20 health controls.The levels of relative biochemical indicators,prothrombin time activity percentage (PTA) and the hepatic fibrosis were determined by biochemical methods.Results The contents of HMGB1 was significantly increased in severe hepatitis patients in comparison with that in chronic hepatitis B patients(P ＜0.01).The contents of HMGB1 in the chronic hepatitis were significantly increased in health controls(P ＜0.01).The contents of HMGB1 had significant difference among the liver cirrhosis patients,the severe hepatitis patients and the chronic hepatitis(P ＜0.01).There was positive correlation among the contents of HMGB1 and total bilirubin (TBIL),the proportionality of aspartate aminotransferase and alanine aminotransferase (AST/ALT),hyaluronic acid (HA) and procollagen Ⅲ N-terminal peptide (P Ⅲ NP) (r = 0.865,0.646,0.783,0.662,P ＜ 0.01).There was negative correlation among the contents of HMGB1 and prothrombin time activity percentage (PTA) and albumin (ALB) (r =-0.915,-0.852,P ＜0.01).Conclusion The contents of serum HMGB1 were closely associated with disease severity in chronic hepatitis B patients.HMGB1 was an index to auxiliary diagnosis hepatic fibrosis.