肝衰竭患者外周血单个核细胞hTERT mRNA及血清Ang-2和ICAM-1水平临床意义探讨  

Clinical implications of peripheral blood mononuclear cell hTERT mRNA and serum Ang-2 and ICAM-1 levels in patients with liver failure

作　　者：赖华梅 王俊 杨玉健 Lai Huamei;Wang Jun;Yang Yujian(Department of Gastroenterology,Chongming Hospital Affiliated to Shanghai Medical College of Health,Shanghai 200000,China)

机构地区：[1]上海健康医学院附属崇明医院消化内科,上海市202150 [2]上海健康医学院附属崇明医院教学办公室,上海市202150

出　　处：《实用肝脏病杂志》2023年第6期851-854,共4页Journal of Practical Hepatology

基　　金：上海市医药科技攻关计划项目(编号:201901151)。

摘　　要：目的初步探讨肝衰竭患者外周血单个核细胞人瑞粒酶逆转录酶(hTERT)mRNA及血清血管生成素-2(Ang-2)和细胞间黏附分子-1(ICAM-1)水平变化的临床意义。方法2019年1月~2021年5月我院诊治的74例肝衰竭患者【亚急性肝衰竭(SALF)13例,慢加急性肝衰竭(ACLF)39例和慢性肝衰竭(CLF)22例】和同期健康体检者30例,分离并检测外周血单个核细胞(PBMC)hTERT mRNA水平,采用ELISA法检测血清Ang-2和ICAM-1水平。结果肝衰竭组PBMC hTERT mRNA、血清Ang-2和ICAM-1水平分别为(0.9±0.3)、(1344.6±55.3)ng/L和(540.2±22.4)ng/ml,显著高于健康人组【分别为(0.4±0.1)、(1062.5±36.2)ng/L和(167.3±15.6)ng/ml,P<0.05】;SALF患者PBMC hTERT mRNA、血清Ang-2和ICAM-1水平分别为(1.5±0.6)、(1507.8±38.2)ng/L和(647.3±26.2)ng/ml,显著高于ACLF患者【分别为(1.2±0.4)、(1398.6±35.8)ng/L和(582.7±24.1)ng/ml,P<0.05】或CLF患者【分别为(0.7±0.2)、(1280.5±46.3)ng/L和(468.9±20.3)ng/m,P<0.05】;经过1~3 m治疗,SALF组死亡3例,ACLF组死亡5例,CLF组死亡4例。结论肝衰竭患者PBMCs hTERT mRNA及血清Ang-2和ICAM-1水平显著升高,它们可能为判断肝损伤程度提供客观依据,值得进一步研究。Objective The purpose of this study was to explore clinical implications of peripheral blood mononuclear cell(PBMC)human telomerase reverse transcriptase(hTERT)mRNA and serum angiopoietin-2(Ang-2)and intercellular adhesion molecuLe-1(ICAM-1)levels in patients with liver failure(LF).Methods 74 patients with LF,including subacute liver failure(SALF)in 13 cases,acute-on-chronic liver failure(ACLF)in 39 cases and chronic liver failure(CLF)in 22 cases,were admitted to our hospital between January 2019 and May 2021,and 30 healthy individuals who had physical examination in our hospital during the same period were selected as the control group.The PBMC hTERT mRNA was assayed by PCR,and serum Ang-2 and ICAM-1 levels were detected by ELISA.Results The PBMC hTERT mRNA,serum Ang-2 and ICAM-1 levels in patients with LF were(0.9±0.3),(1344.6±55.3)ng/L and(540.2±22.4)ng/ml,significantly higher than[(0.4±0.1),(1062.5±36.2)ng/L and(167.3±15.6)ng/ml,respectively,P<0.05]in the healthy control;the PBMC hTERT mRNA,serum Ang-2 and ICAM-1 levels in patients with SALF were(1.5±0.6),(1507.8±38.2)ng/L and(647.3±26.2)ng/ml,all significantly higher than[(1.2±0.4),(1398.6±35.8)ng/L and(582.7±24.1)ng/ml,respectively,P<0.05]in patients with ACLF or[(0.7±0.2),(1280.5±46.3)ng/L and(468.9±20.3)ng/m,respectively,P<0.05]in patients with CLF;at the end of one to three month treatment,three patients with SALF,five patients with ACLF and four patients with CLF died in our series.Conclusion The PBMC hTERT mRNA as well as serum Ang-2 and ICAM-1 levels in patients with LF increase,which might be helpful in judging the severity of the entity and warrants further clinical investigation.

关 键 词：肝衰竭 外周血单个核细胞 人瑞粒酶逆转录酶 血管生成素-2 细胞间黏附分子-1 

分 类 号：R575.3[医药卫生—消化系统]