乙型肝炎相关慢加急性肝衰竭患者血清ANGPTL2、sVAP-1和HMGB1水平变化及其预测预后的价值研究  

Serum ANGPTL2,sVAP-1 and HMGB1 level changes in patients with hepatitis B virus infection-related acute-on-chronic liver failure

作　　者：李士伟 李家国 诸靖 张颖洁 Li Shiwei;Li Jiaguo;Zhu Jing(Department of Emergency,904th Hospital,Joint Service Support Force,Wuxi 214000,Jiangsu Province,China)

机构地区：[1]联勤保障部队第904医院急诊科,江苏省无锡市214000 [2]昆明医科大学第二附属医院胸外科

出　　处：《实用肝脏病杂志》2025年第2期234-237,共4页Journal of Practical Hepatology

基　　金：江苏省卫健委重点科研项目(编号:ZDB2020033)。

摘　　要：目的探讨乙型肝炎相关慢加急性肝衰竭(HBV-ACLF)患者血清血管生成素样蛋白2(ANGPTL2)、可溶性血管粘附蛋白1(sVAP-1)和高迁移率族蛋白1(HMGB1)水平变化及其临床意义。方法2021年12月~2024年2月我院收治的67例HBV-ACLF患者(早期21例,中期26例,晚期20例)、60例慢性乙型肝炎(CHB)患者和60例健康体检者,给予肝衰竭患者常规内科治疗,采用ELISA法检测血清ANGPTL2、sVAP-1和HMGB1水平,常规检测和计算终末期肝病模型(MELD)评分,采用直线相关分析。结果HBV-ACLF组血清ANGPTL2、sVAP-1和HMGB1水平分别为(11.1±2.6)ng/mL、(848.5±237.6)ng/mL和(68.7±15.9)ng/mL,显著高于CHB组【分别为(9.3±2.0)ng/mL、(702.3±208.8)ng/mL和(58.8±12.1)ng/mL,P<0.05】或健康人组【分别为(4.6±1.2)ng/mL、(425.3±103.4)ng/mL和(38.8±8.1)ng/mL,P<0.05】;晚期ACLF组血清ANGPTL2、sVAP-1和HMGB1水平显著高于中期或早期(P<0.05);HBV-ACLF患者血清ANGPTL2、sVAP-1和HMGB1水平与MELD评分呈显著性正相关(r=0.672、r=0.753、r=0.683,P<0.05);30例死亡的HBV-ACLF患者MELD评分及血清ANGPTL2、sVAP-1和HMGB1水平均显著高于37例生存组(P<0.05)。结论HBV-ACLF患者血清ANGPTL2、sVAP-1和HMGB1水平显著升高,可能与病情严重度相关。临床需及时监测这些血清指标并对显著升高的患者予以高度的关注,以改善生存率。Objective The purpose of this study was to investigate changes of serum angiopoietin-like protein 2(ANGPTL2),soluble vascular adhesion protein 1(sVAP-1)and high mobility group box protein 1(HMGB1)levels in patients with hepatitis B virus infection-related acute-on-chronic liver failure(HBV-ACLF).Methods 67 patients with HBV-ACLF(early stage in 21 cases,moderate stage in 26 and terminal stage in 20 cases),60 patients with chronic hepatitis B(CHB)and 60 healthy individuals for physical examination were enrolled in our hospital between December 2021 and February 2024,and serum ANGPTL2,sVAP-1 and HMGB1 levels were assayed by ELISA.Model for end-stage liver disease(MELD)scores were routinely calculated.Linear correlation was applied for correlation analysis.Results Serum ANGPTL2,sVAP-1 and HMGB1 levels in patients with HBV-ACLF were(11.1±2.6)ng/mL,(848.5±237.6)ng/mL and(68.7±15.9)ng/mL,all significantly higher than[(9.3±2.0)ng/mL,(702.3±208.8)ng/mL and(58.8±12.1)ng/mL,respectively,P<0.05]in patients with CHB or[(4.6±1.2)ng/mL,(425.3±103.4)ng/mL and(38.8±8.1)ng/mL,respectively,P<0.05]in healthy control;serum ANGPTL2,sVAP-1 and HMGB1 levels in patients with ACLF at terminal stage were all much higher than in those at moderate or early stages(P<0.05);serum ANGPTL2,sVAP-1 and HMGB1 levels in patients with HBV-ACLF were positively correlated to MELD scores(P<0.05),and they were significantly higher in 30 dead patients than in 37 survivals(P<0.05).Conclusion Serum ANGPTL2,sVAP-1 and HMGB1 levels in patients with HBV-ACLF elevates greatly,which might be related to severity of the entity.Clinicians should put emphasis on surveillance of serum ANGPTL2,sVAP-1and HMGB1,and pay more attention to patients with increased serum markers.

关 键 词：乙型肝炎肝衰竭 血管生成素样蛋白2 血管粘附蛋白1 高迁移率族蛋白1 预后 

分 类 号：R512.62[医药卫生—内科学] R575.3[医药卫生—临床医学]