外周血程序性坏死RIPK1、RIPK3表达与老年患者HBV感染慢性化、重症化的关联性  

Correlation of expression of programmed necrosis related proteins RIPK1 and RIPK3 in peripheral blood with chronicity and severity of HBV infection in elderly patients

作　　者：林芊如 郑娟红 贾杰 LIN Qian-ru;ZHENG Juan-hong;JIA Jie(Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine,Wenzhou,Zhejiang 325000,China)

机构地区：[1]温州市中西医结合医院消化内科,浙江温州325000

出　　处：《中华医院感染学杂志》2024年第15期2313-2317,共5页Chinese Journal of Nosocomiology

基　　金：浙江省中医药科技计划基金资助项目(2020ZB241)。

摘　　要：目的探究外周血程序性坏死中受体相互作用蛋白激酶1(RIPK1)、RIPK3表达水平与乙型肝炎病毒(HBV)慢性化、重症化的关系.方法选择2021年3月—2023年3月于温州市中西医结合医院消化内科就诊的103例HBV感染患者作为研究组,依据患者病情严重程度分为慢性乙型肝炎(CHB)组(n=56)与重症乙型肝炎(CHB-S)组(n=47),同时选择同期到医院体检健康者43名作为对照组;测定并比较各组外周血程序性坏死RIPK1、RIPK3以及HBV-DNA水平,分析外周血RIPK1、RIPK3临床意义.结果研究组患者外周血RIPK1、RIPK3、MLKL表达水平均高于对照组(P<0.05);外周血RIPK1、RIPK3、MLKL与肝纤维化程度呈正相关关系(r=0.613,0.654,0.766;P<0.001),与炎症活动分级也呈正相关关系(r=0.429,0.572,0.491;P<0.001);CHB-S组患者周血RIPK1、RIPK3、MLKL以及HBV-DNA水平均高于CHB组患者(P<0.05);外周血RIPK1、RIPK3、MLKL与HBV-DNA水平呈正相关关系(r=0.455,0.396,0.627;P<0.001);受试者工作特征(ROC)曲线显示,外周血RIPK1、RIPK3、MLKL对HBV感染慢性化与重症化鉴别价值AUC值分别为0.760、0.688、0.877,三指标联合AUC值为0.929.结论外周血程序性坏死RIPK1、RIPK3表达与HBV感染患者慢性化、重症化关系密切,其作用机制可能与肝纤维化、炎症反应以及HBV复制有关.OBJECTIVE To explore the relationship between the expression levels of programmed necrosis receptor-interacting protein kinase 1(RIPK1)and RIPK3 in peripheral blood and the chronicity and severity of hepatitis B virus(HBV)infection.METHODS A total of 103 patients with HBV infection treated in the gastroenterology de-partment of Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine between Mar 2021 and Mar 2023 were selected as the study group.They were divided into the chronic hepatitis B(CHB)group(n=56)and severe hepatitis B(CHB-S)group(n=47)according to the severity of the disease.Meanwhile,43 healthy volunteers under physical examination in the hospital during the same period were included in the control group.The levels of programmed necrosis-related factors of RIPK1,RIPK3 and HBV-DNA in peripheral blood were measured and compared between the two groups.Clinical significance of peripheral blood RIPK1 and RIPK3 levels was analyzed.RESULTS The expression levels of RIPK1,RIPK3 and MLKL in the study group were higher than those in the control group(P<0.05).Peripheral blood RIPK1,RIPK3 and MLKL were positively correlated with the degree of liver fibrosis(r=0.613,0.654,0.766,P<0.001)and the grade of inflammatory activity(r=0.429,0.572,0.491,P<0.001).The levels of peripheral blood RIPK1,R1PK3,MLKL and HBV-DNA in the CHB-S group were higher than those in the CHB group(P<0.05).Peripheral blood expression of RIPK1,RIPK3 and MLKL were positively correlated with HBV-DNA level(r=0.455,0.396,0.627,P<0.001).Re-ceiver operating characteristics(ROC)curve analysis showed that the AUC values of peripheral blood RIPK1,RIPK3 and MLKL in the differentiation of chronic and severe HBV infection were 0.760,0.688 and 0.877,re-spectively.The AUC value of the combined detection of the three indicators was 0.929.CONCLUSION The ex-pression of programmed necrosis RIPK1 and RIPK3 in peripheral blood is closely related to chronicity and severity of HBV infection.The mechanism of action may be related to liver fibrosis,infla

关 键 词：外周血程序性坏死 RIPK1 RIPK3 HBV感染 慢性化 重症化 

分 类 号：R512.62[医药卫生—内科学]