血清sST2在慢性HBV感染者中的表达及其与病情严重程度相关性的研究  

Study on the expression of serum sST2 and its relationship with disease severity in patients with chronic hepatitis B

作　　者：林兰意 姜绍文 莫瑞东[1] 项晓刚[1] 赖荣陶[1] 王晖[1] 赵钢德[1] 蔡伟[1] 郭清[1] 许蓓[1] 谢青[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院感染科,200025 [2]江苏省无锡新区新瑞医院消化科

出　　处：《肝脏》2017年第11期987-990,共4页Chinese Hepatology

基　　金：上海市卫生和计划生育委员会课题(201440482);中国肝炎防治基金会王宝恩肝纤维化研究基金(CFHPC20131056);国家十三五科技重大专项(2017ZX10302201-004-005;2017ZX10203201-008);上海市公共卫生三年行动计划重点学科建设项目传染病与卫生微生物学(15GWZK0102);促进市级医院临床技能与临床创新三年行动计划(16CR1002A)

摘　　要：目的研究血清白细胞介素33(IL-33)/ST2在慢性HBV感染者中的表达特征及其与疾病严重程度的关系。方法筛选并纳入2013年1月至2016年12月瑞金医院感染科收治的慢性HBV感染者105例,其中乙型肝炎相关慢加急性肝衰竭(HBV-ACLF)组46例,慢性乙型肝炎(CHB)组59例,另纳入健康对照(HC)组20名。其中CHB均行肝穿刺活检,根据肝脏病理学Ishak评分分为4个亚组,分别为无或轻度肝纤维化F0-2组(n=12)、中度肝纤维化F3-4组(n=12)、重度肝纤维化F5组(n=12)及肝硬化F6组(n=23)。ELISA法检测患者外周血清IL-33和sST2的表达水平,与病情严重程度进行相关性分析。结果 CHB组中肝硬化F6亚组sST2水平为(21.3±4.7)ng/mL,明显高于F5亚组、F3-4亚组、F0-2亚组[(5.1±0.8)ng/mL、(5.6±0.8)ng/mL、(3.8±0.4)ng/mL,均P<0.05]及HC组[(6.9±0.7)ng/mL,P<0.05],但低于HBV-ACLF组[(63.5±3.9)ng/mL,P<0.01]。所有患者的血清sST2水平与天门冬氨酸氨基转移酶(AST)、总胆红素(TBil)水平呈正相关(均P<0.05),与血清白蛋白、血小板水平呈负相关(均P<0.01),而与丙氨酸氨基转移酶(ALT)水平无显著相关性。血清IL-33水平在各组之间无显著性差异,F6亚组:(4.7±1.0)pg/mL、F5亚组:(4.2±0.7)pg/mL、F3-4亚组:(4.1±1.1)pg/mL、F0-2亚组:(5.4±2.0)pg/mL、HC组:(5.5±0.9)pg/mL、HBV-ACLF组:(5.4±0.5)pg/mL。结论血清sST2表达水平与CHB患者的肝纤维化进展及病情严重程度密切相关,血清IL-33与CHB肝纤维化进程及疾病进展无关。Objective To investigate the role of interleukin-33/ST2 expression in the progression of liver fibrosis,and its relationship with disease severity in patients with chronic hepatitis B(CHB).Methods A total of 105 patients from January2013 to December 2016 in Ruijin hospital were enrolled,containing46 patients with hepatitis B virus(HBV)-related acute-on-chronic liver failure(HBV-ACLF)and 59 patients with CHB.Patients in CHB group all underwent liver biopsy,and were divided into F0-2(non or mild fibrosis)subgroup(n=12),F3-4(moderate fibrosis)subgroup(n=12),F5(advanced fibrosis)subgroup(n=12)and F6(liver cirrhosis)subgroup(n=23)according to Ishak scoring system.Twenty healthy volunteers were enrolled as controls.Serum levels of IL-33 and sST2 of all participants were detected using enzyme linked immunosorbent assay(ELISA),and the relationship between progression of liver fibrosis and disease severity was analyzed.Results Serum sST2 level in F6 subgroup(21.3±4.7 ng/mL)were significantly higher than that in F5,F3-4,F0-2 and control group(5.1±0.8 ng/mL,5.6±0.8 ng/mL,3.8±0.4 ng/mL and 6.9±0.7 ng/mL,all P<0.05),respectively,but was notably lower than that in HBV-ACLF group(63.5±3.9,P<0.001).In all patients,serum levels of sST2 were positively correlated with aspartate aminotransferase(AST)and total bilirubin(TBil)(both P<0.05),but negatively correlated with albumin level and platelet counts(both P<0.001).However,there was no correlation between serum sST2 and ALT levels.The serum levels of IL-33 were 4.7±1.0 pg/mL,4.2±0.7 pg/mL,4.1±1.1 pg/mL,5.4±2.0 pg/mL,5.5±0.9 pg/mL and5.4±0.5 pg/mL in F6,F5,F3-4,F0-2,HC and HBV-ACLF group,respectively,with no statistical significance among these groups.Conclusion Serum sST2,other than serum IL-33,was associated with the progression of liver fibrosis and disease severity in CHB patients.

关 键 词：慢性乙型肝炎 肝纤维化 sST2 

分 类 号：R512.62[医药卫生—内科学]