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*

doi:10.3969/j.issn.1672-5069.2022.02.023

摘要/Abstract

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

郝玉婷, 林洁, 秦杰. 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^*[J]. 实用肝脏病杂志, 2022, 25(2): 243-246.

Hao Yuting, Lin Jie, Qin Jie. Clinical implication of serum aquaporin-8 and aquaporin-9 in patients with hepatitis B-induced liver cirrhosis receiving long-term entecavir therapy[J]. Journal of Practical Hepatology, 2022, 25(2): 243-246.

参考文献

[1] 应灵军,陈华忠,张建伟,等.代偿期乙型肝炎肝硬化患者长期抗病毒治疗后临床特点和肝脏组织学改变.中华临床感染病杂志,2016,9(1):13-18.
[2] Geilswijk M,Thomsen K L,Pedersen E B,et al. Urinary aquaporin-2 excretion before and after transjugular intrahepatic portosystemic shunt insertion for refractory ascites.Scand J Gastroenterol,2015,50(4):454-461.
[3] Busk T M,MLler S,Pedersen E,et al.Aquaporin-2 in cirrhosis: relation to disease severity, markers of renal function and impact on development of renal insufficiency and mortality.J Hepatol,2016,64(2):S669.
[4] Triantos C,Kalafateli M,Aggeletopoulou I,et al. Lactate serum concentrations during treatment with nucleos(t)ide analogues in hepatitis B with or without cirrhosis.Eur J Gastroenterol Hepatol,2017,29(9):998-1003.
[5] 中华医学会肝病学分会和感染病学分会.慢性乙型肝炎防治指南(2019年版).实用肝脏病杂志,2020,23(1):S9-32.
[6] 中华医学会肝病学分会.肝硬化诊治指南.实用肝脏病杂志,2019,22(6):770-792.
[7] 中华医学会肝病学分会.肝硬化腹水及相关并发症的诊疗指南.实用肝脏病杂志,2018,21(1):21-31.
[8] Bräsen JH,Mederacke YS,Schmitz J,et al.Cholemic nephropathy causes acute kidney injury and is accompanied by loss of aquaporin 2 in collecting ducts.Hepatology,2019,69(5):2107-2119.
[9] Vukićević T,Schulz M,Faust D,et al.The trafficking of the water channel aquaporin-2 in renal principal cells-a potential target for pharmacological intervention in cardiovascular diseases.Front Pharmacol,2016,7(62):23-25.
[10] 岳四海,张建国,郭锁成,等.水通道蛋白8在人脑胶质瘤组织的表达及临床意义.中华实验外科杂志,2021,38(3):556-559.
[11] 谷孙泽栋,杨晓飞,张佩欣.恩替卡韦治疗慢性乙型肝炎和乙型肝炎肝硬化患者血清和肝组织可溶性纤维蛋白原样蛋白2水平的变化.实用肝脏病杂志,2019,22(3):405-408.
[12] Okada M,Enomoto M,Kawada N,et al. Effects of antiviral therapy in patients with chronic hepatitis B and cirrhosis.Expert Rev Gastroenterol Hepatol,2017,11(12):1095-1104.
[13] Yu X,Zheng Y,Deng Y,et al.Serum interleukin (IL)-9 and IL-10, but not T-helper 9 (Th9) cells, are associated with survival of patients with acute-on-chronic hepatitis B liver failure.Medicine (Baltimore),2016,95(16):e3405.
[14] 邱侣侣,马师洋,程妍,等.功能性便秘和肠易激综合征便秘型患者结肠黏膜水通道蛋白8的表达与意义.中华消化杂志,2016,36(8):538-542.
[15] Akashi A,Miki A,Kanamori A,et al.Aquaporin 9 expression is required for l-lactate to maintain retinal neuronal survival.Neurosci Lett,2015,589(3):185-190.
[16] Xiang X,You XM,Zhong JH,et al.Hepatocellular carcinoma in the absence of cirrhosis in patients with chronic hepatitis B virus infection. J Hepatol,2017,67(4):885-886.
[17] Hong Y,Chen Z,Li N,et al.Prognostic value of serum aquaporin-1, aquaporin-3, and galectin-3 for young patients with colon cancer.Ann Clin Biochem,2020,57(6):404-411.
[18] Lee S,Kang HG,Ryou C,et al.Spatiotemporal expression of aquaporin 9 is critical for the antral growth of mouse ovarian follicles.Biol Reprod,2020,103(4):828-839.
[19] Nakanishi H,Kurosaki M,Hosokawa T,et al.Urinary excretion of the water channel aquaporin2 correlated with the pharmacological effect of tolvaptan in cirrhotic patients with ascites.J Gastroenterol,2016,51(6):620-627.
[20] An B,Li B,Li H,et al.Aquaporin8 regulates cellular development and reactive oxygen species production, a critical component of virulence in Botrytis cinerea.New Phytol,2016,209(4):1668-1680.
[21] Tanski D,Skowronska A,Eliszewski M,et al.Changes in aquaporin 1, 5 and 9 gene expression in the porcine oviduct according to estrous cycle and early pregnancy.Int J Mol Sci,2020,21(8):2777.
[22] Nakai M,Ogawa K,Takeda R,et al.Increased serum C-reactive protein and decreased urinary aquaporin 2 levels are predictive of the efficacy of tolvaptan in patients with liver cirrhosis.Hepatol Res,2018,48(3):E311-E319.

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^*

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

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