脂肪细胞因子与肝纤维化乙型肝炎患者肝功能、纤维化及炎症活动程度的相关性研究

摘要

目的 探讨肝纤维化乙型肝炎患者脂肪细胞因子与肝功能、纤维化及炎症活动程度的相关性.方法 选择肝纤维化乙型肝炎患者56例为观察组,健康体检者20例为对照组.比较两组网膜素、瘦素、脂联素和内脏脂肪素水平,分析观察组各脂肪细胞因子水平与肝功能指标、HBV-DNA的相关性.观察组行肝组织活检并评价肝组织炎症活动度(HA)和肝组织纤维化分期(HF),比较不同HA分度和不同HF分期患者的脂肪细胞因子水平.结果 两组脂联素、瘦素、内脏脂肪素比较差异均无统计学意义(均P＞0.05),观察组网膜素水平显著高于对照组(P＜0.05).观察组网膜素、内脏脂肪素、瘦素和脂联素与ALT、AST、HBV-DNA均无相关性(均P＞0.05),HA分度0～1者(23例)与HA分度2～3者(33例)各脂肪细胞因子比较差异均无统计学意义(均P＞0.05),HFS1～S2期者(21例)与HFS3～S4期者(35例)脂联素、瘦素和内脏脂肪素比较差异均无统计学意义(均P＞0.05),而网膜素水平升高,差异有统计学意义(P＜0.05).结论 肝纤维化乙型肝炎患者的网膜素水平升高,且与肝纤维化严重程度相关,进一步探讨网膜素与肝纤维化的关系对于预防乙型肝炎后肝硬化可能具有一定的意义.%Objective To investigate the association of serum adipocytokine levels with liver function,severity of fibrosis and inflammatory activity in patients with hepatitis B.Methods Fifty six hepatitis B patients with hepatic fibrosis (study group) and 20 healthy subjects (control group) were enrolled in the study.The serum levels of leptin,adiponectin and visfatin were measured and compared between two groups.Liver biopsy was performed in study group and the inflammatory activity of liver tissue (HA) and hepatic fibrosis staging (HF) were evaluated.The correlation of various serum cytokine levels with liver function,HBV-DNA load,inflammatory activity and fibrosis stages was analyzed by Pearson correlation analysis in study group.Results Serum omentin level in study group was significantly higher than that in control group (P＜0.05),while there were no significant differences in serum adiponectin,leptin and visfatin levels between two groups (all P ＞0.05).Pearson correlation analysis showed that there was no correlation between retinal pigment,visceral fat hormone,leptin,adiponectin and ALT,AST,HBV-DNA in study group (P ＞0.05).There were no significant differences in Serum adiponectin,leptin,visfatin and omenti levels between HA 0-1 (low HA index,n=23) and HA 2-3 (high HA index,n=33) patients (all P ＞0.05),and there were also no differences in adiponectin,leptin and visfatin levels between low HF stage(HFS1-S2,n=21) and high HF stage (HFS3-S4,n=35) patients (all P ＞0.05),however,the omentin level in high HF stage patients was significantly higher than that in low stage patients (P＜0.05).Conclusion Serum omentin level is elevated in hepatitis B patients with liver fibrosis and is associated with liver fibrosis severity.