慢性乙型肝炎及乙型肝炎性肝硬化患者色氨酸代谢变化及其相关性分析

目的 探讨慢性乙型肝炎(CHB)和乙型肝炎性肝硬化(HBC)患者色氨酸(Trp)代谢变化及相关性.方法 选取2015年10月至2016年1月在重庆医科大学附属第一医院住院的CHB 81例和HBC 40例患者为研究对象,40例健康者为对照.采用高效液相色谱-荧光检测法(HPLC-FD)对各组受试者血浆中Trp及代谢产物犬尿氨酸(Kyn)、5-羟色胺(5-HT)水平进行测定,实时荧光定量PCR检测HBV-DNA病毒复制数,分析3组间血清学指标差异,采用Pearson相关分析和Logistic回归分析筛选危险因素.结果 与对照组比较,CHB组、HBC组受试者血浆中Trp和5-HT水平明显降低(P<0.01);HBC组受试者血浆中Kyn/Trp明显高于其他两组(P<0.01).HBC组Kyn/Trp与A/G呈负相关(r=-0.686,P<0.01),CHB组Kyn/Trp与Log DNA呈正相关(r=0.784,P<0.01).Logistic回归分析显示Kyn/Trp为CHB和HBC的危险因素.结论 检测血浆中Trp及其代谢产物可作为辅助指标评估乙型肝炎进展情况.

Tryptophan metabolism change in patients with chronic hepatitis B and hepatitis B cirrhosis and its correlation analysis

Objective To investigate the tryptophan (Trp) metabolism change in the patients with chronic hepatitis B (CHB) and hepatitis B cirrhosis (HBC) and to analyze the related risk .Methods Eighty-one cases of CHB and 40 cases of HBC hospitalized in the First Affiliated Hospital of Chongqing Medical University from October 2015 to January 2016 served as the stud-y subjects ,and 40 healthy persons as the controls .High performance liquid chromatography -fluorescence detection (HPLC-FD) were adopted to detect the levels of plasma Trp ,kynurenine (Kyp) and its metabolite 5-hydroxy tryptamine (5-HT) .HBV-DNA vi-ral replication number was detected by real-time quantitative PCR .The serological indicators differences among 3 groups were ana-lyzed .The risk factors were analyzed and screened by the Logistic regression analysis and Pearson correlation analysis .Results Compared with the control group ,plasma 5-HT and Trp levels in the CHB group and HBC group were significantly decreased (P<0 .01);plasma Kyn/Trp in the HBC group was significantly higher than that in the other two groups (P<0 .01) .Kyn/Trp in the HBC group was negatively correlated with A/G (r= -0 .686 ,P<0 .01) ,and Kyn/Trp in the CHB group was positively correlated with Log DNA (r= 0 .784 ,P<0 .01) .The Logistic regression analysis indicated that Kyn/Trp was the risk factor of CHB and HBC .Conclusion Detecting plasma Trp and its metabolite can serve as the adjuvant indicators for assessing the progression of hep-atitis B .