碱性成纤维细胞生长因子与慢性乙型肝炎及肝纤维化临床检测指标的关系

目的观察碱性成纤维细胞生长因子(b-FGF)在不同肝纤维化分期(S)肝组织中表达的差异性及其与临床检测常用的肝功能指标、肝纤维化指标、HBV DNA复制水平以及肝硬化Child-Pugh分级之间的关系。方法选取122例HBV引起的慢性肝炎及肝硬化患者,空腹静脉血检测:(1)肝功能指标:ALT、TBil、Alb;(2)肝纤维化指标:透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、层粘连蛋白(LN)、Ⅳ型胶原(CⅣ);(3)HBV DNA复制水平;(4)对临床诊断肝硬化患者计算其Child-Pugh评分。行肝脏穿刺活检术后,经病理作纤维化分期(S1～S4)。免疫组织化学法测定肝组织中b-FGF在不同病理分期的表达及定位特点,半定量分析法计算b-FGF值,观察b-FGF与肝功能指标、肝纤维化指标、HBV DNA水平以及肝硬化Child-Pugh分级之间的关系。结果 (1)肝纤维化S1～S4期肝组织中b-FGF的表达部位及水平不同;(2)肝纤维化S1～S4期肝细胞中b-FGF的表达与肝纤维化分期(S1～S4)呈显著正相关(r=0.542,P<0.01);(3)不同肝纤维化分期中b-FGF的表达差异与患者ALT、TBil及Alb进行比较,其差异无统计学意义(P>0.05),不同肝纤维化分期患者,进行HBV DNA检测,其差异无统计学意义(P>0.05);(4)不同肝纤维化分期中,b-FGF与血清纤维化指标HA、PCⅢ、LN、CⅣ之间呈正相关;(5)b-FGF的表达与临床Child-Pugh分级无明显相关性。结论 b-FGF的表达与肝脏纤维化程度、肝纤维化指标有正相关关系,与患者ALT、TBil、Alb、Child-Pugh评分、及HBV DNA水平无关。

The study on relationship of basic fibroblast growth factor with the clinical significance on chronic viral hepatitis B and liver fibrosis

Objective To observe expressions of b-FGF in different stage on the hepatic fibrosis and to discuss the relationship with indexes of hepatic function,indexes of hepatic fibrosis,hepatic cirrhosis Child-Pugh classification,HBV DNA replication.Methods 122 cases of HBV-induced chronic hepatitis and cirrhosis were selected.Delect hepatic function(ALT,TBil,Alb),indexes of liver fibrosis: hyaluronic acid(HA),Ⅲ procollagen(PC Ⅲ),laminin(LN),Ⅳ collagen(CⅣ),HBV DNA replication were tested and hepatic cirrhosis Child-Pugh classification were judged.the pathological diagnosis and different stages of the hepatic fibrosis of 122 patients with chronic hepatitis were determined by liver biopsy.b-FGF Value was calculated,the relationship of b-FGF with indexes of hepatic function,indexes of hepatic fibrosis,HBV DNA replication,hepatic cirrhosis Child-Pugh classification was observed.Results 1.There were some difference of expressions of b-FGF in different parts and levels of liver fibrosis S1-S4 stage.2.The expressions of b-FGF were gradually increased with the development of the hepatic fibrosis(S1-S4) and positive correlation was determined(r=0.542,P<0.01).3.In the different processes of the hepatic fibrosis(S1-S4) the expressions of b-FGF with ALT,TBil,ALB,HBV DNA replication were not statistically significant(P>0.05);4.In the different processes of the hepatic fibrosis(S1-S4) the expressions of b-FGF with HA,PC Ⅲ,LN,CⅣ were positively correlated.5.The expressions of b-FGF and Child-Pugh classification had no correlation.Conclusion The expressions of b-FGF have a positive correlation with the level of hepatic fibrosis and indexes of hepatic fibrosis and there is no correlation of expressions of b-FGF with ALT,TBil,Alb,Child-Pugh score and HBV-DNA replication.