CAJ | 학술논문

目的检测慢加急性肝衰竭患者外周血单个核细胞(PBMC)中硫氧还蛋白-1(Trx-1)、硫氧还蛋白-2(Trx-2)mRNA水平并探讨其临床意义.方法收集60例慢加急性肝衰竭患者(肝衰竭组),38例慢性乙型肝炎患者(慢性乙型肝炎组),26例健康志愿者(正常对照组)的外周血,分离单个核细胞,提取总RNA,用实时定量PCR的方法检测Trx-1、Trx-2 mRNA水平并进行统计分析.结果肝衰竭组患者PBMC中Trx-1、Trx-2的mRNA水平较慢性乙型肝炎组及正常对照组显著升高(P＜0.05).同时,在肝衰竭患者中,Trx-1、Trx-2的mRNA水平与总胆红素水平(TBIL)呈正相关(P＜0.05).Trx-1的mRNA水平与终末期肝病模型(MELD)评分呈正相关(P＜0.05).此外,肝衰竭患者中死亡组Trx-1、Trx-2 mRNA的水平较好转者明显上调(P＜0.05).Kaplan-Meier分析表明,Trx-1 mRNA水平较高的患者预后明显劣于Trx-1 mRNA水平较低的患者(P＜0.05),其中Trx-1的截断值为0.635,敏感度为75％,特异度为64.29％.结论 Trx-1、Trx-2 mRNA及其反应的氧化损伤水平与肝衰竭的疾病严重程度和预后相关,并可能参与了疾病的发生和进展.
목적 검측만가급성간쇠갈환자외주혈단개핵세포(PBMC)중류양환단백-1(Trx-1)、류양환단백-2(Trx-2)mRNA수평병탐토기림상의의.방법 수집60례만가급성간쇠갈환자(간쇠갈조),38례만성을형간염환자(만성을형간염조),26례건강지원자(정상대조조)적외주혈,분리단개핵세포,제취총RNA,용실시정량PCR적방법검측Trx-1、Trx-2 mRNA수평병진행통계분석.결과 간쇠갈조환자PBMC중Trx-1、Trx-2적mRNA수평교만성을형간염조급정상대조조현저승고(P＜0.05).동시,재간쇠갈환자중,Trx-1、Trx-2적mRNA수평여총담홍소수평(TBIL)정정상관(P＜0.05).Trx-1적mRNA수평여종말기간병모형(MELD)평분정정상관(P＜0.05).차외,간쇠갈환자중사망조Trx-1、Trx-2 mRNA적수평교호전자명현상조(P＜0.05).Kaplan-Meier분석표명,Trx-1 mRNA수평교고적환자예후명현렬우Trx-1 mRNA수평교저적환자(P＜0.05),기중Trx-1적절단치위0.635,민감도위75％,특이도위64.29％.결론 Trx-1、Trx-2 mRNA급기반응적양화손상수평여간쇠갈적질병엄중정도화예후상관,병가능삼여료질병적발생화진전.
Objective To investigate the role of Trx-1 and Trx-2 in the progression of hepatitis B associated acute-on-chronic liver failure (ACHBLF).Methods We determined the mRNA levels of Trx1,Trx-2 in peripheral blood mononuclear cells (PBMC) from a cohort of 60 patients with ACHBLF,38 patients with chronic hepatitis B (CHB) and 26 healthy controls by fluorescence real-time quantiative PCR.Results We demonstrated that there were significantly higher expressions of Trx-1 and Trx-2 mRNA in patients with ACHBLF than those patients with CHB and healthy controls (P ＜ 0.05,respectively).Furthermore,the levels of Trx-1 and Trx-2 mRNA significantly correlated with total bilirubin (TBIL) levels in patients with ACHBLF (P ＜ 0.05,respectively).The relative expression of Trx-1 mRNA significantly correlated with model for end-stage liver disease (MELD) scores in patients with ACHBLF (P ＜ 0.05).Besides,Trx-1 and Trx-2 levels were higher in non-survivors with ACHBLF than survivors with ACHBLF (P ＜0.05,respectively).The relative expression of Trx-1 mRNA was predictive of 90-day mortality using Kaplan-Meier analysis (P ＜ 0.05),with a sensitivity of 75％ and a specificity of 64.29％.Conclusion Trx and associated oxidative stress may play an important role in the pathogenesis and progression of ACHBLF,the mRNA level of Trx-1 and Trx-2 may be associated with disease severity and poor prognosis of ACHBLF.