关键词: 慢性乙型肝炎, 肝硬化, 肾素-血管紧张素系统, 肝纤维化

Abstract: ObjectiveTo explore the relationship between the serum levels of proangiotensin （AGT）,angiotensinⅡ（AngⅡ） and angiotensin converting enzyme （ACE） and index of liver fibrosis in patients with chronic hepatitis B（CHB） and HBV-related cirrhosis. Methods One-hundred and eighty patients were divided into normal control group （n=30）,mild hepatitis group （n=30）,moderate hepatitis group（n=30）,and cirrhosis group （n=90）;the patients with cirrhosis were further divided into Child class A,B and C according to individual Child-Pugh score（30 in each）. The levels of AGT,Ang Ⅱ and ACE in serum sample of patients were measured by ELSIA; Serum levels of hyaluronic acid （HA）,laminin （LN）,pro-collagen type Ⅲ（PCⅢ） and collagen type IV（IV-C）were detected by chemiluminescence method. Results Serum levels of HA,LN,PCⅢ,Ⅳ-C,AGT,Ang Ⅱ and ACE in patients with cirrhosis were （350.7±124.9） ng/L,（307.3±139.5） ng/L,（280.3±141.3） ng/L,（256.25±110.42） ng/L,（3.45±0.66） ng/mL,（120.58±26.69） ng/L and （79.70±25.67） U/L,respectively,which were significantly higher than those in normal controls [（68.8±20.7） ng/L,（58.6±20.9） ng/L,（53.0±21.1） ng/L,（47.0±21.1） ng/L,（3.0±0.4） ng/ml,（104.0±13.8） ng/L and （61.6±12.6） U/L,respectively,P<0.05];serum AGT levels in patients with Child-Pugh class A and B were （3.4±0.4） ng/ml and （3.3±0.6） ng/ml,respectively,significantly higher than those in normal controls （P<0.05）;serum Ang Ⅱ and ACE levels in patients with Child class C were （125.4±19.1） ng/L and （83.4±22.5） U/L,respectively,which were significantly higher than those in the normal controls （P<0.05）; No linear correlation could be demonstrated between serum level of AGT,Ang Ⅱor ACE and liver fibrosis indexes. Conclusions Serum levels of AGT,Ang Ⅱ and ACE increase significantly with the progress of liver fibrosis and cirrhosis,but not correlate with indicators of hepatic extracellular matrix metabolism.

Key words: Chronic hepatitis B, Liver cirrhosis, Renin-angiotensin system, Liver fibrosis