非酒精性脂肪性肝病患者肝组织水通道蛋白表达差异与多烯磷脂酰胆碱疗效相关性分析  

Expression difference of liver aquaporins and its correlation with curative effect of multi-phosphatidycholine in nonalcoholic fatty liver disease patients

作　　者：牟东[1] 周德江[1] 江忠勇[2] 陈备金 张勇[1] 曾维政[1] 吴晓玲[1] 

机构地区：[1]成都军区总医院消化内科,成都610083 [2]成都军区总医院检验科,成都610083

出　　处：《第三军医大学学报》2017年第18期1859-1864,共6页Journal of Third Military Medical University

基　　金：四川省卫生厅资助项目(120572)~~

摘　　要：目的分析非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)患者肝组织水通道蛋白(aquaporin,AQPs)3、7、9表达水平对多烯磷脂酰胆碱(plyene posphatidyl coline,PPC)疗效的影响。方法分析2014-2016年本院收治的NAFLD患者87例,按病程分组:肝硬化组(n=30),肝纤维化组(n=24),肝炎组(n=33);超声疗效评估分组:有效组和无效组。随访不同病程的NAFLD患者PPC治疗前后的肝功能酶变化,按照PPC疗效进行分组,比较患者肝组织AQP3、7、9蛋白的表达差异,并进一步分析PPC疗效与AQPs表达水平的相关性。结果 PPC对NAFLD患者治疗整体有效率35.63%,PPC对NAFLD疗效与病程严重程度无关,但与超声的评分密切相关,表现为按照超声评分有效和无效分组的不同病程组患者的谷丙转氨酶(ALT)在PPC治疗后,在每种病程患者中差异有统计学意义,且ALT在PPC治疗后,其变化程度与超声的变化程度呈正相关,肝硬化组(R=0.780,P<0.01),肝纤维化组(R=0.879,P<0.01),肝炎组最高(R=0.900,P<0.01)。PPC治疗NAFLD效果与患者初始的肝组织AQPs的表达存在相关性:NAFLD患者肝组织AQP7、9表达量与肝功能酶的变化量呈正相关(AQP9:R=0.972,AQP7:R=0.537),而AQP3的表达水平与肝功能酶的变化量呈负相关(R=-0.881);AQP7、9表达量与超声评分的变化量呈正相关(AQP9:R=0.763,AQP7:R=0.311),而AQP3的表达水平与肝功能酶的变化量呈负相关(R=-0.795)。结论多烯磷脂酰胆碱对非酒精性脂肪性肝病的疗效与水通道蛋白表达差异密切相关,提示AQPs表达水平可能影响PPC疗效。Objective To determine the effect of expression levels of aquaporins（ AQPs） 3,7 and 9on the therapeutic effect of multi-phosphatidycholine（ PPC） in the patients with nonalcoholic fatty liver disease（ NAFLD）. Methods A total of 87 NAFLD patients admitted in our hospital from 2014 to 2016 were recruited in this study. According to their courses of the disease,they were divided into cirrhosi（ n = 30）,liver fibrosis（ n = 24）,and hepatitis groups（ n = 33）. After the treatment with PPC,ultrasonic examination was used to evaluate the effective and ineffective patients,and the changes of liver function enzymes were also observed. The expression levels of AQPs 3,7 and 9 in the liver tissues were compared in the patients with different courses of NAFLD. The correlation between the effect of PPC and the expression levels of AQPs were analyzed. Results The total effective rate of PPC was 35. 63% in the NAFLD patients,and the effect of PPC on NAFLD was not related to the severity of the disease,but was closely related to the scores of ultrasound examination. Significant differences were found in ALT level between the PPC effective and ineffective patients,and among the patients with difference courses of NAFLD. What＇s more,the ALT level was positively correlated with changes of ultrasound examination in the cirrhosi group（ R = 0. 780,P 〈0. 01）,liver fibrosis group（ R = 0. 879,P 〈0. 01）,and the hepatitis group（ R = 0. 900,P 〈0. 01）. The effect of PPC on NAFLD was correlated with the initial expression levels of AQPs in the liver tissues. The levels of AQPs 7 and 9 were positively correlated with the changes of liver function（ AQP9： R = 0. 972,AQP7： R =0. 537）,and that of AQP 3 was negatively correlated with the changes of liver function enzymes（ R =-0.881）; The expression levels of AQPs 7 and 9 were positively correlated with the change of ultrasonic score（ AQP9： R = 0. 763,AQP7： R = 0. 311）,and that of AQP 3 was negatively correlated with the change of liver func

关 键 词：水通道蛋白 多烯磷脂酰胆碱 非酒精性脂肪肝病 

分 类 号：R575.2[医药卫生—消化系统] R589.2[医药卫生—内科学]