实用肝脏病杂志 ›› 2022, Vol. 25 ›› Issue (2): 243-246.doi: 10.3969/j.issn.1672-5069.2022.02.023

• 肝硬化 • 上一篇    下一篇

长期接受恩替卡韦治疗的乙型肝炎肝硬化患者血清水通道蛋白8和水通道蛋白9变化及其临床意义探讨*

郝玉婷, 林洁, 秦杰   

  1. 100144 北京市 首都医科大学附属北京康复医院检验科(郝玉婷);附属北京中医医院检验科(秦杰);北京大学医学部医院检验科(林洁)
  • 收稿日期:2021-04-27 出版日期:2022-03-10 发布日期:2022-03-15
  • 作者简介:郝玉婷,女,51岁,大学,主管检验师。E-mail:hao19700717@126.com
  • 基金资助:
    *北京市自然科学基金资助项目(编号:8133237)

Clinical implication of serum aquaporin-8 and aquaporin-9 in patients with hepatitis B-induced liver cirrhosis receiving long-term entecavir therapy

Hao Yuting, Lin Jie, Qin Jie   

  1. Clinical Laboratory, Rehabilitation Hospital Affiliated to Capital Medical University, Beijing 100144
  • Received:2021-04-27 Online:2022-03-10 Published:2022-03-15

摘要: 目的 探讨长期应用恩替卡韦治疗的乙型肝炎肝硬化患者血清水通道蛋白8(AQP8)和水通道蛋白9(AQP9)水平变化及其临床意义。方法 2019年1月~2020年6月我院收治的长期接受恩替卡韦治疗的乙型肝炎肝硬化患者83例,继续接受恩替卡韦治疗,使用全自动电化学发光分析仪检测血清AQP8和AQP9水平。采用Logistic逻辑回归模型分析代偿期与失代偿期肝硬化患者各临床因素差异的异同。结果 27例失代偿期肝硬化患者在病程≥10年(63.0%对33.9%)、抗病毒治疗时间≥5年(25.9%对62.5%)、血清白蛋白(31.4±1.9 g/L对37.9±2.3 g/L)、血小板计数(73.8±7.5×109/L对109.6±6.8×109/L)、血清AQP8水平(20.5±2.8 μg/L对12.6±2.1μg/L)、血清AQP9水平(10.1±1.7 μg/L对6.0±1.0 μg/L)和MELD评分(21.5±3.5对13.6±2.9)方面,与56例代偿期肝硬化患者存在显著性差异(P<0.05);多因素Logistic回归分析显著抗病毒治疗时间短、血清AQP8≥15.2 μg/L和MELD评分≥19.5分是影响疾病进展的危险因素(P<0.05);19例有腹水患者血清AQP8和AQP9水平分别为(19.5±2.8)μg/L和(10.7±1.3)μg/L,显著高于64例无腹水患者[分别为(13.9±2.1)μg/L和(6.3±0.9)μg/L,P<0.05];13例有肝性脑病患者血清AQP8和AQP9水平分别为(20.3±2.6)μg/L和(9.7±1.3)μg/L,显著高于70例无肝性脑病患者[分别为(14.2±2.4)μg/L和(6.9±1.1)μg/L,P<0.05]。结论 长期接受恩替卡韦治疗的乙型肝炎肝硬化患者血清AQP8和AQP9水平升高提示病情进展,可能与不良预后有关,值得进一步研究。

关键词: 肝硬化, 乙型肝炎, 恩替卡韦, 水通道蛋白8, 水通道蛋白9, 并发症

Abstract: Objective The purpose of this study was to explore the clinical implication of serum aquaporin-8 (AQP8) and aquaporin-9 (AQP9) in patients with hepatitis B-induced liver cirrhosis (LC) receiving long-term entecavir therapy. Methods A total of 83 patients with hepatitis B-induced LC who received long-term entecavir therapy were enrolled in our hospital between January 2019 and June 2020. Serum AQP8 and AQP9 levels were detected by full-automatic electrochemiluminescence analyzer. The Logistic regression model was applied to analyze the risk factors for disease deterioration. Results There were significant differences as respect to the courses of disease longer than 10 yr(63.0% vs. 33.9%), antiviral therapy longer than 5 yrs (25.9% vs. 62.5%), serum albumin levels(31.4±1.9 g/L vs. 37.9±2.3 g/L)platelet counts (73.8±7.5×109/L vs. 109.6±6.8×109/L), serum AQP8 levels(20.5±2.8 μg/L vs. 12.6±2.1μg/L), serum AQP9 levels (10.1±1.7 μg/L vs. 6.0±1.0 μg/L) and MELD scores (21.5±3.5对13.6±2.9) between 27 patients with decompensated and 56 patients with compensated LC(P<0.05); the multivariate Logistic regression analysis showed that the short antiviral therapy, serum AQP8≥15.2 μg/L and MELD score ≥19.5 were the independent risk factors for disease deterioration of LC(P<0.05); serum AQP8 and AQP9 levels in 19 patients with ascites were (19.5±2.8)μg/L and (10.7±1.3)μg/L, both significantly higher than [(13.9±2.1)μg/L and (6.3±0.9)μg/L, respectively, P<0.05] in 64 patients without ascites; serum AQP8 and AQP9 levels in 13 patients with hepatic encephalopathy (HE) were (20.3±2.6)μg/L and (9.7±1.3)μg/L, significantly higher than [(14.2±2.4)μg/L and (6.9±1.1)μg/L, respectively, P<0.05] in 70 patients without HE. Conclusion Serum AQP8 level elevation might hint disease deterioration in patients with hepatitis B-induced LC receiving long-term entecavir therapy, which warrants further clinical investigation.

Key words: Liver cirrhosis, Hepatitis B, Entecavir, Aquaporin-8, Aquaporin-9, Complications