肝内胆汁淤积性肝病患者血清核因子相关因子2和血红素加氧酶-1水平变化及意义  

Changes of serum nuclear factor E2-related factor 2 and heme oxygenase-1 levels in patients with intrahepatic cholestatic liver disease and their significances

作　　者：张晓倩 杨慧[1] 张晓华 ZHANG Xiaoqian;YANG Hui;ZHANG Xiaohua(Department of Infectious Diseases,the First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一医院感染科

出　　处：《中华实用诊断与治疗杂志》2019年第9期883-886,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：山西省重点研发计划(指南)项目计划任务书(201803D421064);山西卫生和计划生育委员会科研课题计划项目(201601030)

摘　　要：目的探讨血清核因子相关因子2(nuclear factor E2-related factor 2,Nrf2)、血红素加氧酶-1(heme oxygenase-1,HO-1)水平与肝内胆汁淤积性肝病肝损伤的关系及在肝内胆汁淤积性肝病诊断中的价值。方法肝内胆汁淤积性肝病患者60例(观察组),同期体检健康者20例(对照组),比较2组血清Nrf2、HO-1、谷丙转氨酶(glutamic pyruvic transaminase,GPT)、谷草转氨酶(glutamic oxaloacetic transaminase,GOT)、碱性磷酸酶(alkaline phosphatase,ALP)、γ-谷氨酰转肽酶(gamma-glutamyl transferase,GGT)、总胆汁酸(total bile acid,TBA)、总胆红素(total bilirubin,TBiL)、直接胆红素(direct bilirubin,DBiL)水平;观察组依据GPT水平分为轻度肝损伤组(GPT<2倍正常上限)26例、中度肝损伤组(2倍正常上限≤GPT<10倍正常上限)19例、重度肝损伤组(GPT≥10倍正常上限)15例,比较不同肝损伤患者血清Nrf2、HO-1水平;Pearson线性相关法分析观察组血清Nrf2、HO-1与TBiL等指标的相关性;ROC曲线分析血清Nrf2、HO-1诊断肝内胆汁淤积性肝病的效能。结果观察组血清Nrf2[(527.00±168.51)u/L]、HO-1[(15.96±4.90)u/L]、GPT[(215.89±105.51)u/L]、GOT[(209.81±143.23)u/L]、ALP[(336.63±120.44)u/L]、GGT[(376.78±255.70)u/L]、TBA[(34.68±2.04)μmol/L]、TBiL[(43.43±15.11)μmol/L]、DBiL[(18.70±8.23)μmol/L]水平均高于对照组[Nrf2:(164.45±34.10)u/L、HO-1:(11.74±2.00)u/L、GPT:(18.70±6.63)u/L、GOT:(22.40±5.40)u/L、ALP:(73.65±19.36)u/L、GGT:(22.35±7.58)u/L、TBA:(4.78±2.19)μmol/L、TBiL:(12.26±4.40)μmol/L、DBiL:(2.31±0.81)μmol/L](P<0.05);轻、中、重度肝损伤患者血清Nrf2水平[(629.06±171.91)、(533.86±152.19)、(413.37±72.24)u/L]依次降低(P<0.05);轻度肝损伤患者血清HO-1水平[(18.02±5.92)u/L]高于中、重度肝损伤患者[(14.77±4.02)、(13.86±1.56)u/L](P<0.05),中度肝损伤患者与重度肝损伤患者比较差异无统计学意义(P>0.05);观察组血清Nrf2与GPT(r=-0.490,P<0.001)、GOT(r=-0.584,P<0.001)、TBiL(r=-0.740,P<0.00Objective To investigate the relationship of serum nuclear factor E2-related factor 2(Nrf2)and heme oxygenase-1(HO-1)level with liver injury,and the value to the diagnosis of liver injury in patients with intrahepatic cholestatic liver disease.Methods The serum levels of Nrf2,HO-1,glutamic pyruvic transaminase(GPT),glutamic oxaloacetic transaminase(GOT),alkaline phosphatase(ALP),gamma-glutamyl transferase(GGT),total bile acid(TBA),total bilirubin(TBiL)and direct bilirubin(DBiL)were detected in 60patients with intrahepatic cholestatic hepatic disease(observation group)and 20healthy volunteers(control group).In observation group,26patients had GPT level<2×normal upper limit of the normal(ULN)(mild liver injury group),19patients had the GPT level≥2×ULN to<10×ULN(moderate liver damage group)and 15patients had GPT level above≥10×ULN(severe liver injury group).The serum Nrf2and HO-1levels were compared among these three groups.Pearson correlation coefficient was used to analyze the correlation of serum Nrf2and HO-1with TBiL level in observation group.ROC curve was drawn to analyze the efficacy of serum Nrf2and HO-1on the diagnosis of intrahepatic cholestatic liver disease.Results The levels of Nrf2((527.00±168.51)u/L),HO-1((15.96±4.90)u/L),GPT((215.89±105.51)u/L),GOT((209.81±143.23)u/L),ALP((336.63±120.44)u/L),GGT((376.78±255.70)u/L),TBA((34.68±2.04)μmol/L),TBiL((43.43±15.11)μmol/L)and DBiL((18.70±8.23)μmol/L)in observation group were significantly higher than those in control group((164.45±34.10)u/L,(11.74±2.00)u/L,(18.70±6.63)u/L,(22.40±5.40)u/L,(73.65±19.36)u/L,(22.35±7.58)u/L,(4.78±2.19)μmol/L,(12.26±4.40)μmol/L,(2.31±0.81)μmol/L)(P<0.05).The serum Nrf2level decreased gradually in mild,moderate and severe liver injury groups((629.06±171.91),(533.86±152.19),(413.37±72.24)u/L)(P<0.05).The serum HO-1level was significantly higher in mild liver injury group((18.02±5.92)u/L)than that in moderate and severe liver injury groups((14.77±4.02),(13.86±1.56)u/L)(P<0.05),and showed no signi

关 键 词：肝内胆汁淤积性肝病 核因子相关因子2 血红素加氧酶-1 

分 类 号：R28[医药卫生—中药学]