慢性乙型肝炎患者血清内质网应激指标变化及其临床意义*

doi:10.3969/j.issn.1672-5069.2021.04.008

摘要/Abstract

摘要： 目的研究慢性乙型肝炎(CHB)患者血清内质网应激指标水平的变化。方法 2017年5月～2020年5月我院收治的CHB患者109例、乙型肝炎肝硬化患者91例和原发性肝癌(PLC)患者76例,另选择同期健康志愿者120例,采用放射免疫法检测血清透明质酸(HA)、层黏蛋白(LN)、Ⅲ型前胶原肽(PⅢP)和Ⅳ型胶原(Ⅳ-C)水平,采用ELISA法检测血清葡萄糖调节蛋白78(GRP78)、内质网应激转录因子CCAAT/增强子结合蛋白同源蛋白(CHOP)和天冬半胱氨酸特异性蛋白酶-12(caspase-12)水平。结果 CHB组血清ALT、AST、GGT和ALP水平分别为(83.4±21.7)U/L、(63.7±20.5)U/L、(82.2±20.4)U/L和(95.7±20.8)U/L,乙型肝炎肝硬化组分别为(74.3±18.5)U/L、(51.5±18.9)U/L、(84.9±22.5)U/L和(94.8±19.8)U/L,PLC组分别为(70.2±17.7)U/L、(52.6±18.8)U/L、(93.8±24.8)U/L和(106.8±22.4)U/L,均显著高于健康人(P＜0.05);CHB组血清HA、LN、Ⅳ-C和PⅢP水平分别为(84.5±78.9)ng/mL、(52.8±24.1)ng/mL、(61.4±33.0)ng/mL和(10.9±7.4)ng/mL,乙型肝炎肝硬化组分别为(155.2±75.6)ng/mL、(63.1±22.8)ng/mL、(82.2±30.1)ng/mL和(15.4±5.2)ng/mL,PLC组分别为(153.3±73.2)ng/mL、(64.6±20.4)ng/mL、(80.9±28.4)ng/mL和(15.4±3.1)ng/mL,均显著高于健康人【分别为(38.6±14.2)ng/mL、(34.2±13.3)ng/mL、(33.9±10.9)ng/mL和(6.8±1.6)ng/mL,P＜0.05】;CHB组血清GRP78、CHOP和caspase-12水平分别为(44.0±12.4)μg/L、(2485.5±1200.0)μg/L和(699.8±204.2)pmol/L,乙型肝炎肝硬化组分别为(51.7±15.9)μg/L、(2873.1±1314.2)μg/L和(752.2±241.5)pmol/L,PLC组分别为(62.7±17.1)μg/L、(3040.9±1440.3)μg/L和(842.8±289.4)pmol/L,显著高于健康人【分别为(7.3±2.1)μg/L、(833.4±333.5)μg/L和(85.3±13.7)pmol/L,P＜0.05】。结论 CHB患者血清内质网应激指标显著升高,其与发病机制的关系和对治疗的影响值得探讨。

关键词: 慢性乙型肝炎, 内质网应激, 血清葡萄糖调节蛋白78, 内质网应激转录因子CCAAT/增强子结合蛋白同源蛋白, 天冬半胱氨酸特异性蛋白酶-12

Abstract: Objective The aim of this study was to investigate the change of serum endoplasmic reticulum stress parameters in patients with chronic hepatitis B (CHB). Methods 109 patients with CHB, 91 patients with hepatitis B cirrhosis and 76 patients with primary liver cancer (PLC)], and 120 healthyvolunteers were recruited in this study between May 2017 and May 2020, and serum hyaluronic acid (HA) , laminin (LN), type Ⅲ collagen peptide (P Ⅲ P), and collagen type Ⅳ (Ⅳ - C) were assayed by RIA. Serum glucose-regulating protein 78 (GRP78), endoplasmic reticulum stress transcription factor CCAAT/enhancer binding protein homologous protein (CHOP) and aspartic cysteine-specific protease 12 (Caspase-12) were determined by ELISA. Results Serum ALT, AST, GGT and ALP levels in patients with CHB were (83.4±21.7)U/L, (63.7±20.5)U/L, (82.2±20.4)U/L and (95.7±20.8)U/L, they were (74.3±18.5)U/L,(51.5±18.9)U/L,(84.9±22.5)U/L and (94.8±19.8)U/L in patients with liver cirrhosis, and were (70.2±17.7)U/L, (52.6±18.8)U/L, (93.8±24.8)U/L and (106.8±22.4)U/L in patients with PLC, all significantly higher than those in healthy control (P＜0.05); serum HA,LN,Ⅳ-C and PⅢP levels in patients with CHB were (84.5±78.9)ng/mL, (52.8±24.1)ng/mL,(61.4±33.0)ng/mL and (10.9±7.4)ng/mL, in patients with liver cirrhosis were (155.2±75.6)ng/mL,(63.1±22.8)ng/mL, (82.2±30.1)ng/mL and (15.4±5.2)ng/mL, and in patients with PLC were (153.3±73.2)ng/mL, (64.6±20.4)ng/mL, (80.9±28.4)ng/mL and (15.4±3.1)ng/mL, all significantly higher than [(38.6±14.2)ng/mL,(34.2±13.3)ng/mL, (33.9±10.9)ng/mL and (6.8±1.6)ng/mL, respectively,P＜0.05] in healthy control; serum GRP78, CHOP and caspase-12 levels in patients with CHB were (44.0±12.4)μg/L, (2485.5±1200.0)μg/L and (699.8±204.2)pmol/L, in patients with liver cirrhosis were (51.7±15.9)μg/L, (2873.1±1314.2)μg/L and (752.2±241.5)pmol/L, and in patients with PLC were (62.7±17.1)μg/L, (3040.9±1440.3)μg/L and (842.8±289.4)pmol/L, all significantly higher than [(7.3±2.1)μg/L,(833.4±333.5)μg/L and (85.3±13.7)pmol/L,P＜0.05] in healthy persons. Conclusion Endoplasmic reticulum stress is activated in patients with CHB, and its implications warrants further investigation.

Key words: Hepatitis B, Endoplasmic reticulum stress, Glucose-regulating protein 78, CCAAT/enhancer binding protein homologous protein, Caspase-12

吴慧, 宋波, 吕承秀, 田文君, 牛家峰. 慢性乙型肝炎患者血清内质网应激指标变化及其临床意义^*[J]. 实用肝脏病杂志, 2021, 24(4): 484-487.

Wu Hui, Song Bo, Lyu Chengxiu, et al. Change of serum endoplasmic reticulum stress parameters in patients with chronic hepatitis B[J]. Journal of Practical Hepatology, 2021, 24(4): 484-487.

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慢性乙型肝炎患者血清内质网应激指标变化及其临床意义^*

Change of serum endoplasmic reticulum stress parameters in patients with chronic hepatitis B

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