肝硬化门静脉高压症患者脾切除后早期血栓形成与Janus激酶-信号转导和转录激活因子信号通路的关系  

Association of JAK/STAT signaling pathway with portal vein thrombosis after splenectomy in cirrhotic patients with portal hypertension

作　　者：王欢 申晓旭 陈良琪 龚天兰 WANG Huan;SHEN Xiaoxu;CHEN Liangqi;GONG Tianlan(Department of Infectious Diseases,The Affiliated Hospital of Guizhou Medical University,Guizhou 550002,China)

机构地区：[1]贵州医科大学附属医院感染科,贵州550002

出　　处：《临床肝胆病杂志》2022年第10期2260-2264,共5页Journal of Clinical Hepatology

基　　金：贵阳市科技计划([2019]9-5-11)。

摘　　要：目的 探讨肝硬化门静脉高压症患者脾切除后早期血栓形成因素,及其与Janus激酶(JAK)-信号转导和转录激活因子(STAT)信号通路的关系。方法 选择2018年3月—2020年4月在贵州医科大学附属医院因肝硬化门静脉高压行脾切除断流术患者198例,根据患者术后3个月内是否发生门静脉血栓将其分为血栓组(n=41)和非血栓组(n=157)。检测两组患者术后外周血单个核细胞中JAK2 mRNA及STAT3 mRNA表达情况。计量资料组间比较采用t检验,计数资料组间比较采用χ^(2)检验,对可能影响患者术后门静脉血栓形成的各因素进行单因素及多因素Logistic回归分析;采用受试者工作曲线(ROC曲线)分析术后JAK2mRNA、STAT3 mRNA相对表达量对门静脉血栓的预测价值。结果 单因素结果显示,血栓组患者术前门静脉直径、术后门静脉直径、门静脉流速差、脾容积均显著高于非血栓组(t值分别为4.718、3.945、8.671、2.006,P值均<0.05)。术后两组患者外周血单个核细胞JAK2 mRNA及STAT3 mRNA相对表达量较术前均显著升高(t值分别为12.933、15.442、14.386、10.896,P值均<0.05),同时血栓组患者JAK2 mRNA及STAT3 mRNA相对表达量升高程度均明显高于非血栓组(P值均<0.05)。多因素logistic回归分析结果显示,门静脉流速差、术后JAK2 mNRA、术后STAT3 mRNA及术前门静脉直径为影响患者术后门静脉血栓发生的重要因素(P值均<0.05)。患者术后JAK2 mRNA、STAT3 mRNA相对表达量预测门静脉血栓的ROC曲线下面积分别为0.850、0.787。结论 JAK/STAT信号通路激活参与了肝硬化门静脉高压患者脾切除后血栓形成过程,可能是患者术后门静脉血栓形成的重要机制之一,有望成为患者术后门静脉血栓预防和治疗的潜在生物学途径。Objective To investigate the role of the Janus tyrosine kinase(JAK)-signal transducer and activators of transcription(STAT) signaling pathway in thrombosis formation after splenectomy in cirrhotic patients with portal hypertension.Methods A total of 198 liver cirrhosis patients with portal hypertension who underwent splenectomy and devascularization were recruited from March 2018 to April 2020 and then divided into thrombosis(n=41) and non-thrombosis groups(n=157) according to whether portal vein thrombosis occurred 3 months after surgery.mRNA levels of JAK2 and STAT3 in peripheral blood mononuclear cells(PBMCs) were assessed.Comparison of continuous data between groups was performed using t test,while comparison of categorial data between group was performed using chi square test.Clinicopathological data from patients were collected and analyzed for the potential risk factors of portal vein thrombosis by using univariate and multivariate Logistic regression analyses.The prediction values of JAK2 and STAT3 mRNA for portal vein thrombosis were evaluated by area under the receiver operating curve(AUC).Results The diameter of portal vein,the diameter of portal vein,the velocity difference of portal vein and the volume of spleen in the thrombus group were significantly higher than those in the non-thrombus group(t=4.718,3.945,8.671,and 2.006 respectively;P<0.05).The relative mRNA levels of JAK2 and STAT3 in PBMCs of the two groups were significantly increased after surgery(t=12.933,15.442,14.386,10.896;P<0.05),and their levels were also much higher in the thrombosis group than in the non-thrombosis group of patients(P<0.05).Multivariate Logistic regression analytic data showed that the portal vein diameter,the velocity difference of portal vein and mRNA level of JAK2 and STAT3 were all predictors for thrombosis in these patients(P<0.05).The AUC of JAK2 and STAT3 mRNAs was 0.850 and 0.787,respectively in diagnosis of thrombosis in these patients.Conclusion The JAK/STAT signaling was activated in the process of thrombo

关 键 词：肝硬化 高血压 门静脉 脾切除术 

分 类 号：R575.2[医药卫生—消化系统]