中华消化病与影像杂志（电子版）
中華消化病與影像雜誌（電子版）
중화소화병여영상잡지（전자판）
2015年
1期
14-17
,共4页
董丽娴%杨敏%赵洁%王琦%武希润
董麗嫻%楊敏%趙潔%王琦%武希潤
동려한%양민%조길%왕기%무희윤
肝炎,乙型%肝硬化%血小板生成素%Child-Pugh分级%HBV-DNA
肝炎,乙型%肝硬化%血小闆生成素%Child-Pugh分級%HBV-DNA
간염,을형%간경화%혈소판생성소%Child-Pugh분급%HBV-DNA
Hepatitis B%Liver cirrhosis%Thrombopoietin%Child-Pugh grade%HBV-DNA
目的：检测乙型肝炎肝硬化患者促血小板生成素（ TPO ）水平，探讨肝硬化患者不同HBV-DNA载量、Child-Pugh分级、血小板数与血清TPO的关系。方法选取乙型肝炎肝硬化组患者26例，正常对照7例。根据HBV-DNA不同载量分为＜103 IU／ml、103～104 IU／ml、105～106 IU／ml组；根据Child-Pugh分级将乙型肝炎肝硬化分为Child-Pugh A级、Child-Pugh B级、Child-Pugh C级；根据血小板数分为＜50×109／L、50×109／L ～100×109／L、＞100×109／L组。全自动血细胞检测仪测定血小板数， PCR-荧光探针法测定 HBV-DNA，酶联免疫吸附试验（ ELISA ）检测血清 TPO 水平。结果（1）乙型肝炎肝硬化 HBV-DNA 不同载量组 TPO 值均降低[（3.20±2.43）ng／ml、（2.90± 2.52）ng／ml、（2.15±0.85）ng／ml]，与正常对照组[（8.26±2.60）ng／ml]相比，差异均有统计学意义（F＝12.092，P＜0.05）；HBV-DNA不同载量组间差异无统计学意义（t值分别为0.28、1.01、0.69，P＞0.05）。（2）乙型肝炎肝硬化Child-Pugh A级、B级、C级血清TPO值均降低[（2.30±1.21）ng／ml、（3.28±2.79）ng／ml、（2.90±2.13）ng／ml]，与正常对照组[（8.26±2.60） ng／ml]相比，差异均有统计学意义（ F＝12.103， P＜0.05）；不同Child-Pugh 分级组间差异无统计学意义（ t 值分别为－1.02、－0.51、0.32，P＞0.05）。（3）乙型肝炎肝硬化不同血小板数组血清TPO分别为[（3.26±2.03）ng／ml、（2.00±1.05）ng／ml、（3.21±2.57）ng／ml]，与正常对照组[（8.26±2.60）ng／ml]相比，差异均有统计学意义（ F＝12.781， P＜0.05）；不同血小板数组间差异无统计学意义（ t值分别为1.07、0.04、1.29， P＞0.05）。结论乙型肝炎肝硬化患者血清TPO明显减低，可能与肝硬化肝功能改变、HBV-DNA病毒复制、血小板计数有关，但不同Child-Pugh分级、不同HBV-DNA病毒载量、不同血小板计数间血清TPO无明显变化，推测肝硬化患者血清TPO水平受肝硬化多种因素影响。
目的：檢測乙型肝炎肝硬化患者促血小闆生成素（ TPO ）水平，探討肝硬化患者不同HBV-DNA載量、Child-Pugh分級、血小闆數與血清TPO的關繫。方法選取乙型肝炎肝硬化組患者26例，正常對照7例。根據HBV-DNA不同載量分為＜103 IU／ml、103～104 IU／ml、105～106 IU／ml組；根據Child-Pugh分級將乙型肝炎肝硬化分為Child-Pugh A級、Child-Pugh B級、Child-Pugh C級；根據血小闆數分為＜50×109／L、50×109／L ～100×109／L、＞100×109／L組。全自動血細胞檢測儀測定血小闆數， PCR-熒光探針法測定 HBV-DNA，酶聯免疫吸附試驗（ ELISA ）檢測血清 TPO 水平。結果（1）乙型肝炎肝硬化 HBV-DNA 不同載量組 TPO 值均降低[（3.20±2.43）ng／ml、（2.90± 2.52）ng／ml、（2.15±0.85）ng／ml]，與正常對照組[（8.26±2.60）ng／ml]相比，差異均有統計學意義（F＝12.092，P＜0.05）；HBV-DNA不同載量組間差異無統計學意義（t值分彆為0.28、1.01、0.69，P＞0.05）。（2）乙型肝炎肝硬化Child-Pugh A級、B級、C級血清TPO值均降低[（2.30±1.21）ng／ml、（3.28±2.79）ng／ml、（2.90±2.13）ng／ml]，與正常對照組[（8.26±2.60） ng／ml]相比，差異均有統計學意義（ F＝12.103， P＜0.05）；不同Child-Pugh 分級組間差異無統計學意義（ t 值分彆為－1.02、－0.51、0.32，P＞0.05）。（3）乙型肝炎肝硬化不同血小闆數組血清TPO分彆為[（3.26±2.03）ng／ml、（2.00±1.05）ng／ml、（3.21±2.57）ng／ml]，與正常對照組[（8.26±2.60）ng／ml]相比，差異均有統計學意義（ F＝12.781， P＜0.05）；不同血小闆數組間差異無統計學意義（ t值分彆為1.07、0.04、1.29， P＞0.05）。結論乙型肝炎肝硬化患者血清TPO明顯減低，可能與肝硬化肝功能改變、HBV-DNA病毒複製、血小闆計數有關，但不同Child-Pugh分級、不同HBV-DNA病毒載量、不同血小闆計數間血清TPO無明顯變化，推測肝硬化患者血清TPO水平受肝硬化多種因素影響。
목적：검측을형간염간경화환자촉혈소판생성소（ TPO ）수평，탐토간경화환자불동HBV-DNA재량、Child-Pugh분급、혈소판수여혈청TPO적관계。방법선취을형간염간경화조환자26례，정상대조7례。근거HBV-DNA불동재량분위＜103 IU／ml、103～104 IU／ml、105～106 IU／ml조；근거Child-Pugh분급장을형간염간경화분위Child-Pugh A급、Child-Pugh B급、Child-Pugh C급；근거혈소판수분위＜50×109／L、50×109／L ～100×109／L、＞100×109／L조。전자동혈세포검측의측정혈소판수， PCR-형광탐침법측정 HBV-DNA，매련면역흡부시험（ ELISA ）검측혈청 TPO 수평。결과（1）을형간염간경화 HBV-DNA 불동재량조 TPO 치균강저[（3.20±2.43）ng／ml、（2.90± 2.52）ng／ml、（2.15±0.85）ng／ml]，여정상대조조[（8.26±2.60）ng／ml]상비，차이균유통계학의의（F＝12.092，P＜0.05）；HBV-DNA불동재량조간차이무통계학의의（t치분별위0.28、1.01、0.69，P＞0.05）。（2）을형간염간경화Child-Pugh A급、B급、C급혈청TPO치균강저[（2.30±1.21）ng／ml、（3.28±2.79）ng／ml、（2.90±2.13）ng／ml]，여정상대조조[（8.26±2.60） ng／ml]상비，차이균유통계학의의（ F＝12.103， P＜0.05）；불동Child-Pugh 분급조간차이무통계학의의（ t 치분별위－1.02、－0.51、0.32，P＞0.05）。（3）을형간염간경화불동혈소판수조혈청TPO분별위[（3.26±2.03）ng／ml、（2.00±1.05）ng／ml、（3.21±2.57）ng／ml]，여정상대조조[（8.26±2.60）ng／ml]상비，차이균유통계학의의（ F＝12.781， P＜0.05）；불동혈소판수조간차이무통계학의의（ t치분별위1.07、0.04、1.29， P＞0.05）。결론을형간염간경화환자혈청TPO명현감저，가능여간경화간공능개변、HBV-DNA병독복제、혈소판계수유관，단불동Child-Pugh분급、불동HBV-DNA병독재량、불동혈소판계수간혈청TPO무명현변화，추측간경화환자혈청TPO수평수간경화다충인소영향。
Objective To detect serum thrombopoietin ( TPO) level of Hepatitis B cirrhosis patients and to study the relationship between serum TPO level and HBV-DNA load, Child-Pugh grade and platelet count in Hepatitis B patients with liver cirrhosis .Methods Twenty-six Hepatitis B cirrhosis patients and 7 healthy volunteers were included in the study .Patients were divided into <103 IU/ml, 103-104 IU/ml,105-106 IU/ml according to different HBV-DNA load, cirrhosis Child-Pugh A grade, Child-Pugh B grade, Child-Pugh C grade according to the Child-Pugh classification, and<50 ×109/L, 50 ×109-100 ×109/L, >100 × 109/L according to platelet count .Platelet count was detected by full automatic blood cell detector , HBV-DNA load by PCR-fluorescence method , serum TPO by enzyme-linked immunosorbent assay .Results ( 1 ) Compared with normal control group [(8.26 ±2.60) ng/ml], the serum TPO of different HBV-DNA load in Hepatitis B patients with liver cirrhosis decreased significantly [(3.20 ±2.43) ng/ml, (2.90 ±2.52) ng/ml, (2.15 ±0.85) ng/ml], and the differences were statistically significant (F =12.092,P<0.05).The differences among different HBV-DNA load groups were not statistically significant t=0.28,1.01,0.69,P>0.05).(2) The serum TPO of patients with different Child-Pugh classification [(2.30 ±1.21) ng/ml, (3.28 ±2.79) ng/ml, (2.90 ±2.13) ng/ml] decreased significantly compared with normal control group [(8.26 ±2.60) ng/ml] (F=12.103,P<0.05).The differences among different Child-Pugh classification groups were not statistically significant (t =-1.02, -0.51, 0.32,P>0.05).(3)The serum TPO of patients with different platelet count [(3.26 ±2.03) ng/ml, (2.00 ±1.05) ng/ml, (3.21 ±2.57) ng/ml] decreased significantly compared with normal control group [(8.26 ±2.60) ng/ml] (F=12.781,P<0.05).The differences among different platelet count groups were not statistically significant ( t=1.07, 0.04, 1.29, P>00.5 ).Conclusions The serum TPO in Hepatitis B patients with liver cirrhosis is very lower than the normal group .The differences of the serum TPO level among different HBV-DNA load groups, different Child-Pugh grade groups and different platelet count groups are not statistically significant .The serum TPO level may be affected by many factors .
