乙型肝炎相关慢加急性肝衰竭患者血清ANGPTL2、sVAP-1和HMGB1水平变化及其预测预后的价值研究*

doi:10.3969/j.issn.1672-5069.2025.02.019

摘要/Abstract

摘要： 目的探讨乙型肝炎相关慢加急性肝衰竭(HBV-ACLF)患者血清血管生成素样蛋白 2(ANGPTL2)、可溶性血管粘附蛋白1(sVAP-1)和高迁移率族蛋白1(HMGB1)水平变化及其临床意义。方法 2021年12月～2024年2月我院收治的67例HBV-ACLF患者(早期21例,中期26例,晚期20例)、60例慢性乙型肝炎(CHB)患者和60例健康体检者,给予肝衰竭患者常规内科治疗,采用ELISA法检测血清ANGPTL2、sVAP-1和HMGB1水平,常规检测和计算终末期肝病模型(MELD)评分,采用直线相关分析。结果 HBV-ACLF组血清ANGPTL2、sVAP-1和HMGB1水平分别为(11.1±2.6) ng/mL、(848.5±237.6) ng/mL和(68.7±15.9) ng/mL,显著高于CHB组【分别为(9.3±2.0) ng/mL、(702.3±208.8) ng/mL和(58.8±12.1) ng/mL,P＜0.05】或健康人组【分别为(4.6±1.2) ng/mL、(425.3±103.4) ng/mL和(38.8±8.1) ng/mL,P＜0.05】;晚期ACLF组血清ANGPTL2、sVAP-1和HMGB1水平显著高于中期或早期(P＜0.05); HBV-ACLF患者血清ANGPTL2、sVAP-1和HMGB1水平与MELD评分呈显著性正相关(r=0.672、r=0.753、r=0.683,P＜0.05);30例死亡的HBV-ACLF患者MELD评分及血清ANGPTL2、sVAP-1和HMGB1水平均显著高于37例生存组(P＜0.05)。结论 HBV-ACLF患者血清ANGPTL2、sVAP-1和HMGB1水平显著升高,可能与病情严重度相关。临床需及时监测这些血清指标并对显著升高的患者予以高度的关注,以改善生存率。

关键词: 乙型肝炎肝衰竭, 血管生成素样蛋白 2, 血管粘附蛋白1, 高迁移率族蛋白1, 预后

Abstract: Objective The purpose of this study was to investigate changes of serum angiopoietin-like protein 2 (ANGPTL2), soluble vascular adhesion protein 1 (sVAP-1) and high mobility group box protein 1 (HMGB1) levels in patients with hepatitis B virus infection-related acute-on-chronic liver failure (HBV-ACLF). Methods 67 patients with HBV-ACLF (early stage in 21 cases, moderate stage in 26 and terminal stage in 20 cases), 60 patients with chronic hepatitis B (CHB) and 60 healthy individuals for physical examination were enrolled in our hospital between December 2021 and February 2024, and serum ANGPTL2, sVAP-1 and HMGB1 levels were assayed by ELISA. Model for end-stage liver disease (MELD) scores were routinely calculated. Linear correlation was applied for correlation analysis. Results Serum ANGPTL2, sVAP-1 and HMGB1 levels in patients with HBV-ACLF were (11.1±2.6) ng/mL, (848.5±237.6) ng/mL and (68.7±15.9) ng/mL, all significantly higher than [(9.3±2.0) ng/mL, (702.3±208.8) ng/mL and (58.8±12.1) ng/mL, respectively,P<0.05] in patients with CHB or [(4.6±1.2) ng/mL, (425.3±103.4) ng/mL and (38.8±8.1) ng/mL, respectively, P＜0.05] in healthy control; serum ANGPTL2,sVAP-1 and HMGB1 levels in patients with ACLF at terminal stage were all much higher than in those at moderate or early stages (P＜0.05); serum ANGPTL2,sVAP-1 and HMGB1 levels in patients with HBV-ACLF were positively correlated to MELD scores(P＜0.05), and they were significantly higher in 30 dead patients than in 37 survivals(P＜0.05). Conclusion Serum ANGPTL2, sVAP-1 and HMGB1 levels in patients with HBV-ACLF elevates greatly, which might be related to severity of the entity. Clinicians should put emphasis on surveillance of serum ANGPTL2, sVAP-1and HMGB1, and pay more attention to patients with increased serum markers.

Key words: Acute-on-chronic liver failure, Angiopoietin-like protein 2, Vascular adhesion protein 1, High mobility group box protein 1, Prognosis

李士伟, 李家国, 诸靖, 张颖洁. 乙型肝炎相关慢加急性肝衰竭患者血清ANGPTL2、sVAP-1和HMGB1水平变化及其预测预后的价值研究^*[J]. 实用肝脏病杂志, 2025, 28(2): 234-237.

Li Shiwei, Li Jiaguo, Zhu Jing, et al. Serum ANGPTL2, sVAP-1 and HMGB1 level changes in patients with hepatitis B virus infection-related acute-on-chronic liver failure[J]. Journal of Practical Hepatology, 2025, 28(2): 234-237.

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乙型肝炎相关慢加急性肝衰竭患者血清ANGPTL2、sVAP-1和HMGB1水平变化及其预测预后的价值研究^*

Serum ANGPTL2, sVAP-1 and HMGB1 level changes in patients with hepatitis B virus infection-related acute-on-chronic liver failure

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