血管内皮损伤标志物检测在慢性活动型乙型肝炎中的应用

目的通过对慢性活动型乙型肝炎患者血管内皮细胞损伤标志物水平的动态检测分析，观察其在慢性活动型乙型肝炎患者中的变化和临床治疗效果。方法采用双抗体夹心ELISA法和免疫比浊法检测62例慢性活动型乙型肝炎患者和35例输血科献血员标本的血浆可溶性血栓调节蛋白、可溶性血管内皮细胞蛋白C受体及血管性血友病因子水平；同时采用多聚酶链反应技术（PCR）检测乙型肝炎病毒-DNA（HBv-DNA）水平，并进行相关性分析。结果慢性活动型组sTM、sEPCR及vWF水平均明显高于正常对照组（P均〈0．01）；HBV-DNA阳性组sTM、sEPCR及vWF水平均明显高于HBV-DNA阴性组（P均〈0．05）；慢性活动型组经治疗后sTM、sEPCR及vWF水平较活动期明显下降（P均〈O．05）；慢性活动型组sTM与sEPCR、sTM与vWF及sEPCR与vWF之间均呈明显正相关（r分别为0．6576、0．6252、0．6135．P均〈0．01）。结论血管内皮细胞损伤标志物与慢性活动型乙型肝炎病变过程密切相关，联合动态检测sTM、sEPCR及vWF的水平可作为慢性活动型乙型肝炎病情变化和治疗效果的重要观察指标。

The Clinical Significance of the Markers of Endothelial Damage in Patients with Chronic Active HBV Hepatitis

Objective To investigate the clinical significance of soluble thrombomodulin(sTM).endothelial protein C receptor(sEPCR)and von Willebrand factor(vWF) in patients with chronic active HBV hepatitis.Methods The plasma levels of sTM,sEPCR and vWF were successively determined by double antibody sandwich enzyme-linked immunosorbent assay(ELISA) and immunoturbidimetry in 62 patients with chronic active HBV hepatitis and 35 normal ones.At the same time,polymerase chain reaction(PCR) was used to determine HBV-DNA and relative investigation was done.Results The levels of sTM,sEPCR and vWF in the patients group were much higher than those in the normal group(P<0.01);The levels of sTM,sEPCR and vWF in HBV-DNA positive patients were significantly different from those in HBV-DNA negative patients(P<0.05);The levels of above markers in patients with effective therapy were much lower than those in patients at active phase(P<0.05).In patients with chronic active HBV hepatitis,the levels of sTM,sEPCR and vWF each had positive correlation(r=0.657 6,P<0.01;r=(0.625 2),P<0.01;r=(0.613 5),P<0.01).Conclusion sTM,sEPCRand vWF have good relation with the development of chronic active HBV hepatitis.For observation and therapy,it is very important to determine them successively.