中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2011年
7期
511-515
,共5页
牛迎花%弋锐田%刘红莉%陈天艳%张树林%赵英仁
牛迎花%弋銳田%劉紅莉%陳天豔%張樹林%趙英仁
우영화%익예전%류홍리%진천염%장수림%조영인
肝炎病毒,乙型%肝功能衰竭%环氧化酶-2%过氧化物酶体增殖物激活受体γ
肝炎病毒,乙型%肝功能衰竭%環氧化酶-2%過氧化物酶體增殖物激活受體γ
간염병독,을형%간공능쇠갈%배양화매-2%과양화물매체증식물격활수체γ
Hepatitis B virus%Liver failure%Cyclooxygenase-2%Peroxisome proliferator-activated receptor gamma
目的 研究HBV相关慢加急性肝衰竭(ACLF)患者肝组织的环氧化酶-2(COX-2)和过氧化物酶体增殖物激活受体γ(PPAR γ)的表达情况及其与临床指标的相关性.方法 选取ACLF患者35例,HBV相关慢性肝功能衰竭(CLF)患者35例,慢性乙型肝炎(CHB)患者27例及正常对照(NC)者15例,检测患者生物化学指标及HBV DNA水平;免疫组织化学法行肝组织COX-2和PPAR γ染色,检测并分析各组患者肝组织中COX-2和PPAR γ的表达水平及其与临床资料的相关性.多组间比较用Kruskal-Wallis检验,两组间比较用Mann Whitney非参数U检验,双变量的相关分析用Spearman相关分析.结果 ACLF组与CLF组、CHB组和NC组相比,AST、总胆红素、胆固醇、凝血酶原时间、国际标准化比率、纤维蛋白原、终末期肝病模型(MELD)评分差异有统计学意义(P值均<0.01).COX-2染色在肝细胞质呈阳性着色,PPAR γ染色以核阳性为主,亦可见细胞质阳性着色.ACLF、CLF、CHB和NC组肝组织COX-2表达水平评分分别为(4.77±0.95)分、(4.30±1.18)分、(4.65±0.70)分和(2.31±1.12)分,ACLF、CLF和CHB组表达水平高于NC组,差异有统计学意义(z值分别为-5.18、-4.50和-5.32,P值均<0.01);ACLF组高于CLF组,差异有统计学意义(z=-1.98,P<0.05).PPAR γ表达水平评分在ACLF、CLF、CHB和NC组分别为(6.23±1.78)分、(5.34±1.68)分、(5.90±1.06)分和(3.57±1.91)分,ACLF组高于其他各组,与CLF组及NC组相比,差异有统计学意义(z值分别为-2.62和-4.28,P值均<0.01).ACLF组的COX-2表达水平与MELD评分呈正相关(r=0.337,P<0.05),PPAR γ表达水平与HBV DNA水平的对数值呈正相关(r=0.348,P<0.05).结论 COX-2能反映肝脏炎症程度及肝脏损害程度,PPAR γ在慢性HBV感染时上调,并且炎症越明显,上调的幅度越大,可能是肝脏炎症时的保护机制.
目的 研究HBV相關慢加急性肝衰竭(ACLF)患者肝組織的環氧化酶-2(COX-2)和過氧化物酶體增殖物激活受體γ(PPAR γ)的錶達情況及其與臨床指標的相關性.方法 選取ACLF患者35例,HBV相關慢性肝功能衰竭(CLF)患者35例,慢性乙型肝炎(CHB)患者27例及正常對照(NC)者15例,檢測患者生物化學指標及HBV DNA水平;免疫組織化學法行肝組織COX-2和PPAR γ染色,檢測併分析各組患者肝組織中COX-2和PPAR γ的錶達水平及其與臨床資料的相關性.多組間比較用Kruskal-Wallis檢驗,兩組間比較用Mann Whitney非參數U檢驗,雙變量的相關分析用Spearman相關分析.結果 ACLF組與CLF組、CHB組和NC組相比,AST、總膽紅素、膽固醇、凝血酶原時間、國際標準化比率、纖維蛋白原、終末期肝病模型(MELD)評分差異有統計學意義(P值均<0.01).COX-2染色在肝細胞質呈暘性著色,PPAR γ染色以覈暘性為主,亦可見細胞質暘性著色.ACLF、CLF、CHB和NC組肝組織COX-2錶達水平評分分彆為(4.77±0.95)分、(4.30±1.18)分、(4.65±0.70)分和(2.31±1.12)分,ACLF、CLF和CHB組錶達水平高于NC組,差異有統計學意義(z值分彆為-5.18、-4.50和-5.32,P值均<0.01);ACLF組高于CLF組,差異有統計學意義(z=-1.98,P<0.05).PPAR γ錶達水平評分在ACLF、CLF、CHB和NC組分彆為(6.23±1.78)分、(5.34±1.68)分、(5.90±1.06)分和(3.57±1.91)分,ACLF組高于其他各組,與CLF組及NC組相比,差異有統計學意義(z值分彆為-2.62和-4.28,P值均<0.01).ACLF組的COX-2錶達水平與MELD評分呈正相關(r=0.337,P<0.05),PPAR γ錶達水平與HBV DNA水平的對數值呈正相關(r=0.348,P<0.05).結論 COX-2能反映肝髒炎癥程度及肝髒損害程度,PPAR γ在慢性HBV感染時上調,併且炎癥越明顯,上調的幅度越大,可能是肝髒炎癥時的保護機製.
목적 연구HBV상관만가급성간쇠갈(ACLF)환자간조직적배양화매-2(COX-2)화과양화물매체증식물격활수체γ(PPAR γ)적표체정황급기여림상지표적상관성.방법 선취ACLF환자35례,HBV상관만성간공능쇠갈(CLF)환자35례,만성을형간염(CHB)환자27례급정상대조(NC)자15례,검측환자생물화학지표급HBV DNA수평;면역조직화학법행간조직COX-2화PPAR γ염색,검측병분석각조환자간조직중COX-2화PPAR γ적표체수평급기여림상자료적상관성.다조간비교용Kruskal-Wallis검험,량조간비교용Mann Whitney비삼수U검험,쌍변량적상관분석용Spearman상관분석.결과 ACLF조여CLF조、CHB조화NC조상비,AST、총담홍소、담고순、응혈매원시간、국제표준화비솔、섬유단백원、종말기간병모형(MELD)평분차이유통계학의의(P치균<0.01).COX-2염색재간세포질정양성착색,PPAR γ염색이핵양성위주,역가견세포질양성착색.ACLF、CLF、CHB화NC조간조직COX-2표체수평평분분별위(4.77±0.95)분、(4.30±1.18)분、(4.65±0.70)분화(2.31±1.12)분,ACLF、CLF화CHB조표체수평고우NC조,차이유통계학의의(z치분별위-5.18、-4.50화-5.32,P치균<0.01);ACLF조고우CLF조,차이유통계학의의(z=-1.98,P<0.05).PPAR γ표체수평평분재ACLF、CLF、CHB화NC조분별위(6.23±1.78)분、(5.34±1.68)분、(5.90±1.06)분화(3.57±1.91)분,ACLF조고우기타각조,여CLF조급NC조상비,차이유통계학의의(z치분별위-2.62화-4.28,P치균<0.01).ACLF조적COX-2표체수평여MELD평분정정상관(r=0.337,P<0.05),PPAR γ표체수평여HBV DNA수평적대수치정정상관(r=0.348,P<0.05).결론 COX-2능반영간장염증정도급간장손해정도,PPAR γ재만성HBV감염시상조,병차염증월명현,상조적폭도월대,가능시간장염증시적보호궤제.
Objective To study the expressions of cyclooxygenase-2 (COX-2) and Peroxisome proliferator-activated receptor gamma (PPAR γ) in liver of patients with hepatitis B virus (HBV) related acute-on-chronic liver failure (ACLF) and their correlation with clinical parameters. Methods 35 patients with ACLF, 35 patients with HBV related chronic liver failure (CLF), 27 patients with chronic hepatitis B (CHB) and 15 normal control were enrolled to study the expressions of COX-2 and PPAR γ in the liver tissues by immunohistochemical staining, and to analyze the correlation of the COX-2 and PPAR γ levels in liver tissues with clinical parameters. Results COX-2 was distinctly expressed in the cytoplasm of the hepatocytes, but PPAR γ was mostly expressed in the nuclei of the hepatocytes and also could be seen in the cytoplasm. The expressions of COX-2 in the liver of ACLF, CLF and CHB groups increased significantly as compared with NC group (z = -5.18, -4.50, -5.32, P < 0.01). The levels of COX-2 in ACLF livers also increased evidently as compared with CLF groups (z = -1.98, P < 0.05). The expression levels of PPAR γ in ACLF liver tissues were much higher than the other three groups, and statistical significances existed between ACLF group and the other two groups (CLF, NC groups) (z = -2.62, -4.28, P < 0.01). In ACLF group, the expression of COX-2 correlated with MELD score (r = 0.337, P < 0.05) and the expression of PPAR γ correlated with HBV DNA load (r = 0.348, P < 0.05). Clinical data showed that the levels of AST, TBil, CHOL, PT, INR, FIB and MELD score in ACLF group were significantly different from that in CLF, CHB and NC groups. Conclusions COX-2 expressed in liver may be a marker to reflect the degree of inflammation and injury of liver tissue. The PPAR γ expression of liver could be increased during chronic HBV infection and may be a protective mechanism against liver injury..
