国际流行病学传染病学杂志
國際流行病學傳染病學雜誌
국제류행병학전염병학잡지
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY AND INFECTIOUS DISEASE
2011年
2期
95-99
,共5页
李艳芳%刘友德%强春倩%邹志强%郎振为
李豔芳%劉友德%彊春倩%鄒誌彊%郎振為
리염방%류우덕%강춘천%추지강%랑진위
肝炎,乙型,慢性%非酒精性脂肪肝%肝损伤%α-平滑肌肌动蛋白%脂联素
肝炎,乙型,慢性%非酒精性脂肪肝%肝損傷%α-平滑肌肌動蛋白%脂聯素
간염,을형,만성%비주정성지방간%간손상%α-평활기기동단백%지련소
Hepatitis B,chronic%Non-alcoholic fatty liver disease%liver injuries%α-smooth muscle actin%Adiponectin
目的 研究慢性乙型肝炎(CHB)合并非酒精性脂肪肝(NAFLD)患者的肝损伤与肝脏脂联素及α-平滑肌肌动蛋白(α-SMA)表达的相关性,并探讨CHB患者发生NAFLD的机制.方法 对94例CHB合并NAFLD患者(病例组)进行肝活检,与119例单纯CHB患者(对照组)进行比较,包括血清肝脏生化学及病毒学指标;对肝活检样本进行组织学及脂联素、α-SMA免疫组织化学染色并测量积分吸光度值.结果 病例组血清ALT、总胆固醇、甘油三酯、低密度脂蛋白水平均高于对照组(Z=3.425、4.488、4.858、2.265,P<0.05);HBV DNA定量及HBeAg状态在两组间差异无统计学意义(z=0.825,χ2=0.323,P>0.05).脂联素表达在病例组与脂变、炎症及纤维化程度均无明显相关性(r=0.032、-0.107、-0.133,P>0.05);而在对照组与炎症及纤维化程度呈负相关(r=-0.223、-0.259,P<0.05).α-SMA表达在病例组与炎症及纤维化程度呈明显正相关(r=0.323、0.355,P<0.05);在对照组无相关性(r=0.172、0.155,P>0.05).结论 NAFLD的发生主要与代谢因素有关,而与病毒因素无关;脂联素与CHB合并NAFLD的肝损伤无直接关系;α-SMA可能是判断CHB合并NAFLD患者肝脏炎症及纤维化程度的重要指标;NAFLD可能促进了CHB患者肝损伤的进展.
目的 研究慢性乙型肝炎(CHB)閤併非酒精性脂肪肝(NAFLD)患者的肝損傷與肝髒脂聯素及α-平滑肌肌動蛋白(α-SMA)錶達的相關性,併探討CHB患者髮生NAFLD的機製.方法 對94例CHB閤併NAFLD患者(病例組)進行肝活檢,與119例單純CHB患者(對照組)進行比較,包括血清肝髒生化學及病毒學指標;對肝活檢樣本進行組織學及脂聯素、α-SMA免疫組織化學染色併測量積分吸光度值.結果 病例組血清ALT、總膽固醇、甘油三酯、低密度脂蛋白水平均高于對照組(Z=3.425、4.488、4.858、2.265,P<0.05);HBV DNA定量及HBeAg狀態在兩組間差異無統計學意義(z=0.825,χ2=0.323,P>0.05).脂聯素錶達在病例組與脂變、炎癥及纖維化程度均無明顯相關性(r=0.032、-0.107、-0.133,P>0.05);而在對照組與炎癥及纖維化程度呈負相關(r=-0.223、-0.259,P<0.05).α-SMA錶達在病例組與炎癥及纖維化程度呈明顯正相關(r=0.323、0.355,P<0.05);在對照組無相關性(r=0.172、0.155,P>0.05).結論 NAFLD的髮生主要與代謝因素有關,而與病毒因素無關;脂聯素與CHB閤併NAFLD的肝損傷無直接關繫;α-SMA可能是判斷CHB閤併NAFLD患者肝髒炎癥及纖維化程度的重要指標;NAFLD可能促進瞭CHB患者肝損傷的進展.
목적 연구만성을형간염(CHB)합병비주정성지방간(NAFLD)환자적간손상여간장지련소급α-평활기기동단백(α-SMA)표체적상관성,병탐토CHB환자발생NAFLD적궤제.방법 대94례CHB합병NAFLD환자(병례조)진행간활검,여119례단순CHB환자(대조조)진행비교,포괄혈청간장생화학급병독학지표;대간활검양본진행조직학급지련소、α-SMA면역조직화학염색병측량적분흡광도치.결과 병례조혈청ALT、총담고순、감유삼지、저밀도지단백수평균고우대조조(Z=3.425、4.488、4.858、2.265,P<0.05);HBV DNA정량급HBeAg상태재량조간차이무통계학의의(z=0.825,χ2=0.323,P>0.05).지련소표체재병례조여지변、염증급섬유화정도균무명현상관성(r=0.032、-0.107、-0.133,P>0.05);이재대조조여염증급섬유화정도정부상관(r=-0.223、-0.259,P<0.05).α-SMA표체재병례조여염증급섬유화정도정명현정상관(r=0.323、0.355,P<0.05);재대조조무상관성(r=0.172、0.155,P>0.05).결론 NAFLD적발생주요여대사인소유관,이여병독인소무관;지련소여CHB합병NAFLD적간손상무직접관계;α-SMA가능시판단CHB합병NAFLD환자간장염증급섬유화정도적중요지표;NAFLD가능촉진료CHB환자간손상적진전.
Objective To study the expression of adiponectin and α-smooth muscle actin (α-SMA) in liver from the patients of chronic hepatitis B(CHB) overlapped non-alcoholic fatty liver disease( NAFLD), and to explore the mechanism of CHB patients with NAFLD. Methods 94 patients of CHB overlapped NAFLD (case group)underwent liver biopsy, 119 cases of patients with CHB alone (control group) as control, the fasting venous blood sample was taken for liver biochemical and virological indicators. Liver biopsy specimens were immunohistochemically stained for histology, adiponectin and α-SMA, and integral absorbance. Results The serum ALT, total cholesterol, triglyceride, low density lipoprotein cholesterol and fasting glucose levels in case group were significantly higher than that in control group (Z = 3.425,4.488,4.858、2.265, P < 0.05) .There was no significant difference in HBV DNA viral load and HBeAg between the two groups( Z = 0.825, χ2 = 0.323, P > 0.05). In case group, adiponectin expression was no significant correlation with steatosis, inflammation and fibrosis(r = 0.032, -0.107, -0.133, P>0.05); however, in control group adiponectin was negatively related to inflammation and fibrosis(r= -0.223, -0.259,P<0.05). In case group,α-SMA expression was significant correlation with inflammation and fibrosis( r = 0.323,0.355, P < 0.05). In control group, its expression was no correlation with inflammation and fibrosis( r = 0.172,0.155, P > 0.05). Conclusions The occurrence of NAFLD is mainly related to metabolic factors and no relation with viral factors. Adiponectin is not directly related to liver injury of patients of CHB overlapped NAFLD. α-SMA may be important indicator of liver injury,and NAFLD may promote the progress of liver injury in patients with CHB.
