慢性乙型肝炎患者血清中高尔基体蛋白73水平变化与恩替卡韦抗病毒疗效的相关性  

Correlation between serum levels of Golgi protein 73 and antiviral efficacy of entecavir in patients with chronic hepatitis B

作　　者：蔡建刚[1] 朱婷婷[1] 刘芙蓉[1] 黄志刚[1] 

机构地区：[1]武警浙江省总队医院嘉兴分院传染科,浙江省嘉兴市314000

出　　处：《世界华人消化杂志》2016年第15期2379-2383,共5页World Chinese Journal of Digestology

摘　　要：目的:通过对慢性乙型肝炎患者血清中高尔基体蛋白73(Golgi protein 73,GP73)水平变化与恩替卡韦抗病毒疗效相关性研究,探讨血清GP73对慢性乙型肝炎(chronic viral hepatitis B,CHB)患者病情变化的临床价值.方法:选取2013-01/2015-06在武警浙江省总队医院嘉兴分院就诊的CHB患者483例.选择同期健康体检者63例作为对照.采用ELISA法检测血清GP73浓度,同时对483例CHB患者行肝组织免疫组织化学染色检查.183例CHB患者接受恩替卡韦(entecavir,ETV)抗病毒治疗1年以上,观察治疗前及治疗后1、3、6、9、12 mo的血清GP73浓度变化.结果:慢性CHB患者血清GP73水平明显高于健康对照组(F=191.60,P=0.000),且随着患者病情进展,血清GP73水平亦显著升高,组间对比差异有统计学意义;在慢性CHB患者中,随着肝组织GP73表达的增强,血清中G P73浓度亦同步升高,组间对比差异有统计学意义(P=0.01);CHB患者中,经ETV抗病毒治疗组患者血清GP73浓度显著低于未接受治疗组,高于健康对照组,组间对比差异有统计学意义(P=0.01);相关性分析结果显示:CHB患者血清中GP73浓度与肝组织GP73表达水平呈正相关;与ETV抗病毒治疗疗程呈负相关(P<0.05).结论:血清GP73水平与慢性CHB感染者疾病进展密切相关,可作为慢性CHB患者抗病毒治疗临床疗效评估的参考指标.AIM： To investigate the correlation between serum levels of Golgi protein 73（GP73） and antiviral efficacy of entecavir（ETV） in patients with chronic hepatitis B（CHB） to evaluate the value of GP73 in monitoring the progression and outcome of CHB. METHODS： A total of 483 CHB patients were included, and 63 healthy persons were used as controls. Serum levels of GP73 were detected by ELISA, and liver tissues were collected from 51 CHB patients for detecting GP73 expression by immunohistochemical staining. The correlation between serum GP73 concentrations and GP73 expression in liver tissues was examined. One hundred and eighty-three CHB patients received ETV antiviral treatment for more than 1 year, and serum GP73 concentrations were determined before treatment and 1, 3, 6, 9, and 12 after treatment. RESULTS： In patients with chronic HBV infection, serum GP73 level was significantly higher than that of the healthy control group（F = 191.60, P = 0.000）. With the progression of the disease, serum GP73 concentration continued to significantly rise（P = 0.000）. Serum GP73 levels were positively correlated with severity of chronic HBV infection（r = 0.576, P = 0.000）. With the increase of GP73 expression in liver tissue, serum GP73 concentrations also increased simultaneously（F = 7.285, P = 0.01）. Serum GP73 concentration was positively correlated with the expression of GP73 in liver tissues（r = 0.592, P = 0.00）. In 186 CHB patients treated with ETV for more than 1 years, with the recovery of the disease, serum GP73 concentrations significantly decreased, and there was a significant difference between before and after treatment（P = 0.005）. CONCLUSION： Serum GP73 levels are closely related to the disease progression of chronic HBV infection. The decrease of serum GP73 concentration in the course of ETV antiviral therapy suggests that the liver inflammatory injury is relieved. Serum GP73 can be used to monitor the prognosis of patients with chronic liver disease.

关 键 词：乙型肝炎病毒 慢性肝炎 高尔基体蛋白73 恩替卡韦 

分 类 号：R512.62[医药卫生—内科学]