CAJ | 학술논문

目的：探讨慢性重型乙型肝炎患者血清中 Slit2蛋白水平，以及其与患者肝脏损伤程度、预后的关系。方法将某院感染病科2014年2—7月住院及门诊收治的病毒性肝炎慢性乙型（慢性肝炎组）患者、病毒性肝炎慢性重型乙型（慢性重型肝炎组）患者纳入研究，健康志愿者为正常对照组，慢性重型肝炎组患者根据病情恢复情况再细分为恢复组和未恢复组，比较血清中 Slit2蛋白、凝血酶原活动度（PTA）、总胆红素（TBIL）、谷丙转氨酶（ALT）水平，并进行相关性分析。结果共纳入慢性乙型肝炎患者157例（其中慢性肝炎组93例、慢性重型肝炎组64例）和健康志愿者10例（健康对照组），3组之间 Slit2蛋白水平比较，差异有统计学意义（F＝5．596，P ＝0．004），慢性肝炎组和慢性重型肝炎组患者血清中 Slit2蛋白分别为（4．90±1．07）ng／mL、（3．09±1．00）ng／mL，均高于健康对照组[（2．10±0．60）ng／mL]（均 P ＜0．05）；慢性重型肝炎组患者血清 Slit2蛋白水平低于慢性肝炎组（P ＜0．05）。慢性重型肝炎未恢复组患者血清 Slit2蛋白水平为（1．88±0．67）ng／mL，低于慢性重型肝炎恢复组[（2．96±1．32） ng／mL]，差异有统计学意义（t＝2．319，P ＝0．032）。慢性乙型肝炎患者血清 Slit2蛋白水平与 PTA 呈正相关（r ＝0．33，P ＜0．05）；与 TBIL 水平、ALT 水平呈负相关（r 值分别为－0．46、－0．32，均 P ＜0．05）。结论血清 Slit2蛋白水平是反映慢性重型肝炎患者预后的重要指标，低水平 Slit2预示着预后不佳。
목적：탐토만성중형을형간염환자혈청중 Slit2단백수평，이급기여환자간장손상정도、예후적관계。방법장모원감염병과2014년2—7월주원급문진수치적병독성간염만성을형（만성간염조）환자、병독성간염만성중형을형（만성중형간염조）환자납입연구，건강지원자위정상대조조，만성중형간염조환자근거병정회복정황재세분위회복조화미회복조，비교혈청중 Slit2단백、응혈매원활동도（PTA）、총담홍소（TBIL）、곡병전안매（ALT）수평，병진행상관성분석。결과공납입만성을형간염환자157례（기중만성간염조93례、만성중형간염조64례）화건강지원자10례（건강대조조），3조지간 Slit2단백수평비교，차이유통계학의의（F＝5．596，P ＝0．004），만성간염조화만성중형간염조환자혈청중 Slit2단백분별위（4．90±1．07）ng／mL、（3．09±1．00）ng／mL，균고우건강대조조[（2．10±0．60）ng／mL]（균 P ＜0．05）；만성중형간염조환자혈청 Slit2단백수평저우만성간염조（P ＜0．05）。만성중형간염미회복조환자혈청 Slit2단백수평위（1．88±0．67）ng／mL，저우만성중형간염회복조[（2．96±1．32） ng／mL]，차이유통계학의의（t＝2．319，P ＝0．032）。만성을형간염환자혈청 Slit2단백수평여 PTA 정정상관（r ＝0．33，P ＜0．05）；여 TBIL 수평、ALT 수평정부상관（r 치분별위－0．46、－0．32，균 P ＜0．05）。결론혈청 Slit2단백수평시반영만성중형간염환자예후적중요지표，저수평 Slit2예시착예후불가。
Objective To evaluate serum Slit2 protein level in patients with chronic severe hepatitis B,and the re-lation with extent of liver damage and prognosis of patients.Methods In February-July 2014,patients with chronic hepatitis B(chronic hepatitis group)and chronic severe hepatitis B(chronic severe hepatitis group)in an infectious department were observed,healthy volunteers were as control group,and patients in chronic severe hepatitis group were subdivided into recovery subgroup and non-recovery subgroup based on whether patients had recovered.Serum Slit2 protein,prothrombin activity (PTA),total bilirubin (TBIL),and alanine transaminase (ALT)levels were detected and compared.Results A total of 157 patients (chronic hepatitis group,n =93;chronic severe hepatitis group,n=64)and 10 healthy volunteers were included in the study .Slit2 protein levels were significantly different among three groups(F =5.596,P =0.004),serum Slit2 protein levels in chronic hepatitis group and chronic severe hepatitis group were (4.90±1 .07)ng/mL and (3.09±1 .00)ng/mL respectively,both were higher than (2.10± 0.60)ng/mL in healthy control group (both P <0.05);serum Slit2 protein level in chronic severe hepatitis group was significantly lower than chronic hepatitis group (P <0.05).Serum Slit2 protein level in non-recovery subgroup of chronic severe hepatitis group was significantly lower than recovery subgroup ([1 .88±0.67]ng/mL vs [2.96± 1 .32]ng/mL,t=2.319,P =0.032).Serum Slit2 protein level in patients with chronic hepatitis B was positively correlated with PTA level(r=0.33,P <0.05),but negatively correlated with serum TBIL level (r =-0.46,P <0.05)and ALT level (r=-0.32,P <0.05).Conclusion Serum Slit2 protein level is an important index which can re-flect the prognosis of patients with chronic severe hepatitis,low serum Slit2 level suggests the poor clinical prognosis.