目的 探讨血清脂联素(APN)浓度与慢性乙型肝炎肝纤维化的关系.方法 选择我院传染科2013年1月至2015年6月期间收治的63例慢性乙型肝炎肝纤维化患者,根据肝纤维化程度分为轻度组(n=28)、重度组(n=22)、肝硬化组(n=13),并选择30例健康体检者纳入对照组,检测各组受检者的血清APN浓度及透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PC-Ⅲ)和Ⅳ型胶原(C-Ⅳ)浓度,并比较慢性乙型肝炎患者抗病毒治疗前后上述指标水平的变化.结果 血清APN浓度在对照组、轻度组、重度组及肝硬化组分别为(6.41±2.21)μg/mL、(9.46±3.27)μg/mL、(15.11±4.30)μg/mL、(20.54±5.52)μg/mL,两两比较依次上升,血清HA、LN、PC-Ⅲ、C-Ⅳ浓度也依次上升,差异均有统计学意义(P<0.05),且血清APN浓度与肝纤维化分级之间存在正相关性(P<0.05);肝纤维化患者抗病毒治疗后血清APN及HA、LN、PC-Ⅲ、C-Ⅳ均明显降低,与治疗前比较差异均有统计学意义(P<0.05).结论 脂联素与慢性乙型肝炎肝纤维化的发生、发展关系密切,血清脂联素浓度可反映肝纤维化的程度及抗病毒治疗后肝纤维化的改善程度.%Objective To investigate the relationship between serum adiponectin (APN) concentration and liver fibrosis in patients with chronic hepatitis B. Methods Sixty-three patients with chronic hepatitis B and liver fibrosis treat-ed in Department of Infectious Diseases of our hospital from January 2013 to June 2015 were studied, which were divided into mild group (n=28), severe group (n=22) and cirrhosis group (n=13) according to the degree of liver fibrosis. Thirty healthy volunteers were included into the control group. The serum APN concentration and haluronic acid (HA), laminin (LN), type Ⅲ procollagen (PC-Ⅲ), type Ⅳ collagen (C-Ⅳ) concentrations were detected in all the subjects. The index levels were detected and compared in patients with chronic hepatitis B before and after antiviral therapy. Results The se-rum APN concentration in the control group, mild group and severe group and cirrhosis group were increased successively, with (6.41±2.21)μg/mL, (9.46±3.27)μg/mL, (15.11±4.30)μg/mL, (20.54±5.52)μg/mL, respectively, and HA, LN, PC-Ⅲ, C-Ⅳalso increased in turn, with statistically significant differences (P<0.05). Serum APN concentration showed a pos-itive correlation with liver fibrosis grading (P<0.05). In liver fibrosis patients, the serum APN and HA, LN, PC-Ⅲ, C-Ⅳwere significantly lower after antiviral therapy, compared with those before treatment (P<0.05). Conclusion Adiponectin concentrations is closely related to the liver fibrosis in chronic hepatitis B process, and serum adiponectin concentrations can reflect the degree of liver fibrosis and improvement degree of liver fibrosis after anti-viral therapy.
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