慢性乙型肝炎合并非酒精性脂肪性肝病患者血清反应性氧化物和脂联素水平变化

doi:10.3969/j.issn.1672-5069.2021.02.014

摘要/Abstract

摘要： 目的分析慢性乙型肝炎(CHB)合并非酒精性脂肪性肝病(NAFLD)患者血清反应性氧化物(ROS)和脂联素(ADPN)水平的变化。方法 2018年1月～2020年1月我院收治的CHB合并NAFLD患者97例和CHB患者97例,采用全自动生化分析仪检测血生化指标,采用ELISA法检测血清ROS、ADPN和肿瘤坏死因子-α(TNF-α)水平,应用NAFLD肝纤维化评分(NFS)系统评估NFS评分,使用瞬时弹性扫描仪行肝硬度检测(LSM)和受控衰减参数(CAP)。结果 CHB合并NAFLD患者血清GGT水平为(96.5±13.3)U/L,显著高于CHB组【(67.3±12.5)U/L,P<0.05】;CHB合并NAFLD患者血清FPG、TC、TG和LDL-C水平分别为(5.9±1.0)mmol/L、(5.2±1.1)mmol/L、(2.8±0.4)mmol/L和(2.8±0.4)mmol/L,显著高于CHB组【分别为(4.9±1.0)mmol/L、(4.1±0.8)mmol/L、(1.7±0.3)mmol/L和(2.2±0.3)mmol/L,P<0.05】,而HDL-C为(0.9±0.2)mmol/L,显著低于CHB组【(1.2±0.2)mmol/L,P<0.05】;CHB合并NAFLD患者血清ROS和TNF-α水平分别为(1.7±0.4)U/mL和(32.6±5.4)ng/L,显著高于CHB组【分别为(0.9±0.2)U/mL和(21.5±4.8)ng/L,P＜0.05】,而血清ADPN水平为(8.7±1.9)ng/mL,显著低于CHB组【(10.2±2.3)ng/mL,P＜0.05】;CHB合并NAFLD患者NFS、LSM和CAP分别为(0.2±0.1)分、(10.2±1.3)kPa和(287.4±44.3)dB/m,均显著高于CHB组【分别为(-1.4±0.1)分、(9.1±1.2)kPa和(242.5±38.7)dB/m,P＜0.05】。结论 CHB合并NAFLD患者血清ROS明显升高,而血清ADPN水平显著下降,可能参与了其发病过程。

关键词: 非酒精性脂肪性肝病, 慢性乙型肝炎, 反应性氧化物, 脂联素, 受控衰减参数

Abstract: Objective The aim of this study was to investigate serum reactive oxygen species (ROS) and adiponectin (ADPN) level changes in patients with chronic hepatitis B (CHB) and non-alcoholic fatty liver diseases (NAFLD).Methods 97 patients with CHB and NAFLD and 97 patients with CHB were recruited in our hospital between January 2018 and January 2020, and serum ROS, ADPN and tumor necrosis factor-α (TNF-α) were detected by ELISA. The liver fibrosis was assessed by NAFLD fibrosis scoring (NFS) system. The liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were detected by FibroScan.Results Serum GGT level in patients with CHB and NAFLD was (96.5±13.3)U/L, significantly higher than 【(67.3±12.5)U/L, P<0.05】 in patients with CHB; serum FPG, TC, TG and LDL-C levels in patients with CHB and NAFLD were (5.9±1.0)mmol/L, (5.2±1.1)mmol/L, (2.8±0.4)mmol/L and (2.8±0.4)mmol/L, all significantly higher than 【(4.9±1.0)mmol/L,(4.1±0.8)mmol/L,(1.7±0.3)mmol/L and (2.2±0.3)mmol/L, respectively, P<0.05】, while serum HDL-C was (0.9±0.2)mmol/L, much lower than 【(1.2±0.2)mmol/L, P<0.05】 in patients with CHB; serum ROS and TNF-α levels were (1.7±0.4)U/mL and (32.6±5.4)ng/L, both significantly higher than 【(0.9±0.2)U/mL and (21.5±4.8)ng/L,P＜0.05】, while serum ADPN level was (8.7±1.9)ng/mL, much lower than 【(10.2±2.3)ng/mL, P＜0.05】 in patients with CHB; the NFS score, LSM and CAP were (0.2±0.1), (10.2±1.3)kPa and (287.4±44.3)dB/m, all significantly higher than 【(-1.4±0.1), (9.1±1.2)kPa and (242.5±38.7)dB/m, respectively, P＜0.05】 in patients with CHB.Conclusion Serum ROS level significantly increases, while serum ADPN level greatly decreases in patients with CHB and NAFLD, and the mechanism by which they take part in the pathogenesis of the coexisted entity needs further investigation.

Key words: Non-alcoholic fatty liver disease, Hepatitis B, Reactive oxygen species, Adiponectin, Controlled attenuation parameter

王松姣, 张宇晨, 龚国富, 王宇学. 慢性乙型肝炎合并非酒精性脂肪性肝病患者血清反应性氧化物和脂联素水平变化[J]. 实用肝脏病杂志, 2021, 24(2): 204-207.

Wang Songjiao , Zhang Yuchen , Gong Guofu , et al. Serum reactive oxygen species and adiponectin levels in patients with chronic hepatitis B and concomitant non-alcoholic fatty liver diseases[J]. Journal of Practical Hepatology, 2021, 24(2): 204-207.

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