慢加急性肝衰竭患者外周血PBMC中Trx-1、Trx-2表达水平研究  

Increased peripheral mRNA levels of Trx-1 and Trx-2 associated with the progression of hepatitis Binduced acute-on-chronic liver failure

作　　者：杨阳[1] 范玉琛[1] 赵泽华[1] 纪相芬 窦橙云[1] 张建军[1] 王凯[1] 

机构地区：[1]山东大学齐鲁医院肝病科,山东大学肝病研究所,济南250012

出　　处：《中华实验和临床病毒学杂志》2014年第2期102-104,共3页Chinese Journal of Experimental and Clinical Virology

摘　　要：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-2mRNA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-2mRNA的水平较好转者明显上调（P〈0．05）。Kaplan—Meier分析表明，Trx．1mRNA水平较高的患者预后明显劣于Trx-1mRNA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-2mRNA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。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 Trx- 1, 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 quantiativc 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-I 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.

关 键 词：硫氧还蛋白 氧化性应激 肝炎病毒 乙型 

分 类 号：R575.3[医药卫生—消化系统]