HIV/HCV混合感染者肝纤维化与肠道微生物移位的相关性研究  

Correlation between Liver fibrosis and microbial translocation in patients with HIV/HCV co-infection

作　　者：张德发[1] 马萍[1] 李爽[2] 于芳芳[1] ZHANG De-fa;MA Ping;LI Shuang;YU Fang-fang(Second Comrunicable Diseases Department,Tianjin Second People's Hospital,Tianjin,300192,China;Endoscopie Diagnosis and Treaument Department,Tianjin Second People's Hospital,Tianjin,300192,China)

机构地区：[1]天津市第二人民医院感染二科,天津300192 [2]天津市第二人民医院内镜诊疗科,天津300192

出　　处：《职业与健康》2021年第12期1704-1707,共4页Occupation and Health

基　　金：“十三五”艾滋病和病毒性肝炎等重大传染病防治专项基金(2018ZX10302104)。

摘　　要：目的研究人免疫缺陷病毒/丙型肝炎病毒(HIV/HCV)混合感染者肝纤维化与肠道微生物移位的关系。方法选取天津市第二人民医院感染Ⅱ科2016年1月—2020年1月HIV/HCV共感者、HIV感染者、HCV感染者及健康对照各30例,用弹性瞬时成像(FibroScan)评估肝纤维化程度;检测外周血中转化生长因子-β1(TGF-β1)、白细胞分化抗原14[CD14(mCD14、sCD14)]水平,评估肠道免疫状态。应用统计学方法评估相关性。结果 4组研究对象中HIV/HCV共感组纤维化程度最重,其纤维化测定指标Fiborsacn为(10.72±1.82)Kpa,而健康人群对照组为(3.13±0.26)Kpa、HCV患者组为(9.75±1.16)Kpa、HIV患者组为(3.85±0.53)Kpa。各组肝纤维化指数Fibroscan检测差异有统计学意义(P<0.01)。Pearson相关性分析结果显示,TGF-β1水平与Fibroscan水平呈负相关(r=-0.885,P<0.01),而mCD14、sCD14水平则与Fibroscan水平呈正相关(r=0.932,P<0.01)。结论 HIV/HCV混合感染者肝纤维化程度最重,其体内肠道微生物移位可能与加速肝纤维化进程有关。Objective To investigate the correlation between liver fibrosis and microbial translocation in patients with HIV/HCV co-infection. Methods Totally 30 patients with human immunodeficiency virus(HIV)/hepatitis C virus(HCV) co-infection,30 patients with HIV infection,30 patients with HCV infection and 30 healthy controls were collected from the Second Communicable Diseases Department of Tianjin Second People’s Hospital from January 2016 to January 2020. Liver fibrosis degree was measured with transient elastography(FibroScan). The levels of transforming growth factor-β1( TGF-β1) and leukocyte differentiation antigen 14[CD14(mCD14,sCD14)] in peripheral blood were tested to evaluate the intestinal immune status. Statistical methods were used to evaluate the correlation. Results Among the four groups,the degree of fibrosis was the most serious in HIV/HCV coinfection group,and its fibrosis index Fiborsacn was(10.72±1.82) Kpa,while that in normal control group,HCV infection group and HIV infection group was(3.13±0.26),(9.75±1.16) and(3.85±0.53) Kpa,respectively. There was statistically significant difference in fibrosis index Fiborsacn among four groups(P<0.01). Pearson correlation analysis showed that TGF-β1 level was negatively correlated with FibroScan level(r=-0.885,P<0.01),whilemCD14 and sCD14 levels were positively correlated with FibroScan level(r = 0.932,P <0.01). Conclusion The degree of fibrosis is the most serious in HIV/HCV co-infection group,and the microbial translocation may be related to the acceleration of liver fibrosis.

关 键 词：人免疫缺陷病毒 丙型肝炎病毒 肝纤维化 微生物移位 

分 类 号：R181.32[医药卫生—流行病学]