非酒精性脂肪性肝病伴乙型肝炎病毒复制患者CD44异常表达加重肝病进展  

Abnormal expression of CD44 aggravates liver disease progression in patients with non-alcoholic fatty liver disease accompanied with hepatitis B virus replication

作　　者：吴小飞[1,2] 沙春秀 杨君伶 刘莹[3] 周平 姚登福 姚敏[3] Wu Xiaofei;Sha Chunxiu;Yang Junling;Liu Ting;Zhou Ping;Yao Dengfu;Yao Min(Research Center of Clinical Medicine,Affiliated Hospital of Nantong University,Nantong 226001;Department of Infectious Diseases,Affiliated Haian Hospital of Nantong University,Haian 226401;Department of Medical Immunology,Medical School of Nantong University,Nantong 226001,China)

机构地区：[1]南通大学附属医院临床医学研究中心,南通226001 [2]南通大学附属海安医院感染性疾病科,海安226401 [3]南通大学医学院医学免疫学系,南通226001

出　　处：《中华肝脏病杂志》2021年第11期1083-1088,共6页Chinese Journal of Hepatology

基　　金：国家自然科学基金(31872738、81673241);南通市科技项目(MS12020021)。

摘　　要：目的分析非酒精性脂肪性肝病(NAFLD)伴乙型肝炎病毒(HBV)感染者CD44表达及其临床意义。方法经医院伦理委员会同意, 收集住院NAFLD、单纯慢性乙型肝炎和肝硬化患者血液, 以健康体检人群作为对照, 用酶联免疫吸附法定量分析血清CD44水平以及临床病理学特征;用流式细胞术分析NAFLD及慢性乙型肝炎患者CD44+T淋巴细胞比率;并以高脂饮食制备NAFLD模型验证CD44异常表达。用方差分析或校正t检验比较组间差异, 用χ2检验比较组间阳性率。结果与健康人群组比较, 肝硬化组、慢性乙型肝炎组和NAFLD组血清CD44浓度表达升高, 组间差异有统计学意义(P < 0.01);轻度或重度NAFLD组患者均伴肝细胞损伤, 血糖、血脂或CD44异常;在NAFLD患者伴HBV感染组中, HBsAg、HBeAg和HBV DNA阳性患者血CD44浓度均显著高于HBsAg、HBeAg和HBV DNA阴性组(P < 0.01)。外周血CD44+淋巴细胞比率, 在NAFLD组为78.2%±16.3%, 在慢性乙型肝炎组为68.5%±20.9%, 两组均显著高于健康对照组(46.5%±20.5%)(P < 0.05);高脂饮食模型证实鼠脂肪堆积的鼠肝组织中CD44过表达、伴肝细胞损伤, 尤其在含诱癌剂的肝组织更显著。结论 NAFLD患者CD44异常表达, 可能与HBV相关肝病的恶性转化相关。Objective To analyze the expression of CD44 in non-alcoholic fatty liver disease(NAFLD)accompanied with hepatitis B virus(HBV)infection and its clinical significance.Methods Blood sample of hospitalized patients with NAFLD,chronic hepatitis B,cirrhosis,and healthy population(control)was collected.The study was approved by the hospital ethics committee.Serum CD44 level and clinopathological characteristics were analyzed quantitatively by enzyme-linked immunosorbent-assay.Flow cytometry was used to analyze the proportion of CD44 T lymphocytes in patients with NAFLD and chronic hepatitis B.NAFLD model was prepared with high-fat diet to verify the abnormal expression of CD44.Results Compared with the healthy control group,the expression of serum CD44 in the cirrhosis group,chronic hepatitis B group and NAFLD group was increased,and the difference between the groups were statistically significant(P<0.01).NAFLD patients graded as mild or severe group were equally accompanied by hepatocytc injury,abnonnal blood glucose,lipid or CD44.In NAFLD patients accompanied with HBV infection,semm CD44 concentrations were significantly higher in HBsAg,HBeAg and HBV DNA positive group than HBsAg,HBeAg and HBV DNA negative group(P<0.01).The proportion of CD44 T lymphocytes in peripheral blood of NAFLD and chronic hepatitis B group were 78.2%±16.3%and 68.5%±20.9%,respectively,and both groups(NAFLD and chronic hepatitis B)were significantly higher than the healthy control group(46.5%±20.5%)(Z7<0.05).The high-fat diet model confirmed that in rat liver tissues the CD44 was overexpressed with fat deposition accompanied with liver cell damage,especially remarkable in liver tissues containing carcinogens.Conclusion The abnormal expression of CD44 in patients with NAFLD may be related to the malignant transformation of HBV-related liver disease.

关 键 词：非酒精性脂肪性肝病 T淋巴细胞 模型 慢性肝病 CD44 

分 类 号：R512.62[医药卫生—内科学] R575.5[医药卫生—临床医学]