慢性肝炎患者血流动力学指标及血清细胞因子与疾病严重程度的关系探究  

Relationship between Hemodynamic Indexes,Serum Cytokines and Disease Severity in Patients with Chronic Hepatitis

作　　者：田安娜 TIAN Anna(Fushun Infectious Diseases Hospital,Fushun 113001,China)

机构地区：[1]辽宁省抚顺市传染病医院,辽宁抚顺113001

出　　处：《中国医学创新》2021年第31期125-129,共5页Medical Innovation of China

摘　　要：目的:探讨慢性肝炎患者的血流动力学指标及相关血清细胞因子的表达情况及其与疾病严重程度的关系,以期进一步明确疾病的发生发展,为临床诊疗提供依据。方法:选取2018年9月-2020年7月于本院治疗的119例慢性肝炎患者,根据严重程度分为轻度组、中度组、重度组及肝硬化组。另选取本院46例健康体检者为对照组。比较各组肝纤维化指标(HA、LN、Ⅳ-C)以及血清细胞因子(KLF2、TNFSF15、TGF-β1、VEGF);比较各组肝静脉最大截面直径(DHV)、脾静脉最大截面直径(DSV)、门静脉主干最大截面直径(DPV)、血流速度(VPV)及肝静脉频谱波形。结果:轻、中、重度组及肝硬化组DPV均高于对照组,而VPV均低于对照组(P<0.05);中、重度组及肝硬化组DHV均低于对照组,而重度组和肝硬化组的DSV均高于对照组(P<0.05)。轻、中、重度组及肝硬化组DPV、DSV逐渐升高,DHV、VPV逐渐降低,差异均有统计学意义(P<0.05)。中、重度组及肝硬化组的Ⅰ、Ⅱ型频谱波形比例均低于对照组与轻度组(P<0.05),且中、重度组及肝硬化组Ⅰ、Ⅱ型频谱波形比例逐渐降低(P<0.05);肝硬化组Ⅲ、Ⅳ型频谱波形比例均高于其余四组(P<0.05)。五组INR比较,差异均无统计学意义(P>0.05)。各组肝纤维化指标及细胞因子水平比较,差异均有统计学意义(P<0.05)。轻、中、重度组及肝硬化组HA、LN、Ⅳ-C、KLF2、TGF-β1、VEGF逐渐上升(P<0.05);轻、中、重度组及肝硬化组TNFSF15逐渐降低(P<0.05)。KLF2、TGF-β1、VEGF、DPV和DSV与各项肝纤维化指标及疾病严重程度均呈正相关(P<0.05),而TNFSF15、VPV、DHV与肝纤维化指标各项肝纤维化指标及疾病严重程度均呈负相关(P<0.05)。结论:慢性肝炎患者的血流动力学指标及细胞因子参数能反映出患者肝功能损害的严重程度,在临床诊断和治疗中有着重要的参考价值。Objective:To investigate the expression of hemodynamic indexes and related serum cytokines in patients with chronic hepatitis and their relationship with disease severity,so as to further clarify the occurrence and development of the disease and provide basis for clinical diagnosis and treatment.Method:A total of 119 patients with chronic hepatitis treated in our hospital from September 2018 to July 2020 were selected and divided into mild group,moderate group,severe group and cirrhosis group according to their severity.Another 46 healthy subjects in our hospital were selected as the control group.Liver fibrosis indexes(HA,LN,Ⅳ-C)and serum cytokines(KLF2,TNFSF15,TGF-β1,VEGF)were compared among all groups.The DHV,DSV,DPV,VPV and hepatic vein spectral waveform were compared among all groups.Result:DPV of mild,moderate,severe and cirrhosis groups were higher than that of control group,while VPV were lower than that of control group(P<0.05).DHV in moderate,severe and cirrhosis groups were lower than that in control group,while DSV in severe and cirrhosis groups were higher than that in control group(P<0.05).DPV and DSV increased gradually in mild,moderate,severe and cirrhosis groups,while DHV and VPV decreased gradually,with statistical significance(P<0.05).The proportions of typeⅠand typeⅡspectrum waveform in moderate,severe and cirrhosis groups were lower than those in control group and mild group(P<0.05),and the proportions of typeⅠand typeⅡspectrum waveform in moderate,severe and cirrhosis groups were gradually decreased(P<0.05).The proportion of typeⅢand typeⅣspectrum waveform in cirrhosis group were higher than those in other four groups(P<0.05).There was no significant difference in INR among the five groups(P>0.05).There were statistically significant differences in liver fibrosis indexes and cytokine levels among all groups(P<0.05).HA,LN,Ⅳ-C,KLF2,TGF-β1 and VEGF were increased gradually in mild,moderate,severe and cirrhosis groups(P<0.05).TNFSF15 decreased gradually in mild,moderate,severe

关 键 词：慢性肝炎 肝硬化 血流动力学 细胞因子 

分 类 号：R575.1[医药卫生—消化系统]