Correlation between Serum Levels of Anti-HBC,CHE,and Apolipoprotein AI and the Development of Viral Hepatitis
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摘要:
目的 探讨血清乙型肝炎病毒核心抗体(hepatitis B core anbody,抗-HBC)、胆碱酯酶(cholinesterase,CHE)、载脂蛋白AI的水平与病毒性肝炎发展的相关性。 方法 选取南京市浦口区中医院2021年1月至2024年1月收治的388例病毒性肝炎患者作为观察组;另选取同期68例健康体检者作为对照组,比较观察组与对照组血清抗-HBC、CHE、载脂蛋白AI水平。比较观察组中慢性肝炎不同病情严重程度患者血清抗-HBC、CHE、载脂蛋白AI水平。比较观察组中不同疾病类型患者血清抗-HBC、CHE、载脂蛋白AI检测阳性例数。比较观察组中肝硬化不同分级患者血清抗-HBC、CHE、载脂蛋白AI水平。 结果 观察组血清抗-HBC水平(4.52±0.63)log10PEIU/mL高于对照组(1.12±0.26)log10PEIU/mL,差异有统计学意义(t = -43.822,P < 0.001),而CHE(4.09±0.91)kU/L、载脂蛋白AI102.54±5.95)mg/dL均低于对照组的(10.65±1.73)kU/L、(120.17±6.06)mg/dL,差异有统计学意义(t = 46.580、22.477,P < 0.001);观察组中慢性肝炎不同病情严重程度患者血清抗-HBC、CHE、载脂蛋白AI水平差异均有统计学意义(P < 0.05),且血清抗-HBC水平显示慢性肝炎轻度 < 慢性肝炎中度 < 慢性肝炎重度,而CHE、载脂蛋白AI水平显示慢性肝炎轻度 > 慢性肝炎中度 > 慢性肝炎重度,差异有统计学意义(P < 0.05);慢性肝炎重度、肝硬化及肝癌的血清抗-HBC、CHE、载脂蛋白AI的阳性例数明显高于慢性肝炎轻度、中度,差异有统计学意义(P < 0.05);观察组中肝硬化不同分级患者血清抗-HBC、CHE、载脂蛋白AI水平差异有统计学意义(P < 0.05),且随病情的发展血清抗-HBC水平不断增高,而CHE、载脂蛋白AI均不断降低,差异有统计学意义(P < 0.05)。 结论 病毒性肝炎患者血清抗-HBC的表达水平显著升高,CHE、载脂蛋白AI的表达水平明显降低,且血清抗-HBC、CHE、载脂蛋白AI的表达水平与其疾病发展相关。 Abstract:Objective To investigate the correlation between serum hepatitis B core anbody (anti-HBC), cholinesterase (CHE) and apolipoprotein AI (ApoAI) and the development of viral hepatitis. Methods 388 patients with viral hepatitis admitted to Nanjing Pukou District Hospital of Traditional Chinese Medicine from January 2021 to January 2024 were selected as the observation group, another 68 cases of health check-ups in medical check-up centre of Nanjing Pukou District Hospital of Traditional Chinese Medicine during the same period were selected as the control group. The serum levels of anti-HBC, CHE, and apolipoprotein AI between the observation group and the control group were compared. To compare the serum anti-HBC, CHE, ApoAI levels in patients with different disease severity of chronic hepatitis in the observation group. To compare the number of positive cases of serum anti-HBC, CHE, ApoAI in patients with different disease types in the observation group. To compare the serum anti-HBC, CHE, ApoAI levels in patients with different grades of cirrhosis in the observation group. Results Serum anti-HBC levels (4.52±0.63) log10PEIU/mL were higher in the observation group than in the control group (1.12±0.26) log10PEIU/mL, and the differences were statistically significant (t = -43.822, P < 0.001) , while CHE (4.09±0.91) kU/L, ApoAI (102.54±5.95) mg/dL were lower than the control group(10.65±1.73) kU/L, (120.17±6.06) mg/dL, and the differences were statistically significant (t = 46.580, 22.477, P < 0.001); differences in serum anti-HBC, CHE, and ApoAI levels among patients with different severity of chronic hepatitis in the observation group were statistically significant(P < 0.05), and the serum levels of anti-HBC levels showed mild chronic hepatitis < moderate chronic hepatitis < severe chronic hepatitis, while the levels of CHE and ApoAI showed mild chronic hepatitis > moderate chronic hepatitis > severe chronic hepatitis the difference was statistically significant (P < 0.05); the number of positive cases of serum anti-HBC, CHE, ApoAI in acute jaundiced hepatitis, severe chronic hepatitis, cirrhosis and hepatocellular carcinoma were significantly higher than those of chronic hepatitis in mild and moderate forms and the difference was statistically significant (P < 0.05). The differences in serum anti-HBC, CHE, and ApoAI levels in patients with different grades of cirrhosis in the observation group were statistically significant (P < 0.05) and serum levels of anti-HBC levels increased continuously with the progression of the disease, whereas CHE and ApoAI decreased continuously with the difference being statistically significant (P < 0.05). Conclusion The levels of serum anti-HBC in patients with viral hepatitis are significantly increased, while the levels of CHE and apolipoprotein AI are significantly decreased, and the levels of serum anti-HBC, CHE and apolipoprotein AI are related to the development of the disease, which contributes to the development of the disease. -
Key words:
- Viral hepatitis /
- Hepatitis B core anbody /
- Cholinesterase /
- Apolipoprotein
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表 1 2组血清抗-HBC、CHE、载脂蛋白AI水平比较($ \bar x \pm s $)
Table 1. Comparison of serum levels of anti-HBC,CHE and ApoAI between the two groups($ \bar x \pm s $)
组别 血清抗-HBC(log10PEIU/mL) CHE(kU/L) 载脂蛋白AI(mg/dL) 观察组(n = 388) 4.52 ± 0.63 4.09 ± 0.91 102.54 ± 5.95 对照组(n = 68) 1.12 ± 0.26 10.65 ± 1.73 120.17 ± 6.06 t −43.822 46.580 22.477 P < 0.001* < 0.001* < 0.001* *P < 0.05。 表 2 观察组慢性肝炎患者血清抗-HBC、CHE、载脂蛋白AI水平比较($ \bar x \pm s $)
Table 2. Comparison of serum anti-HBC, CHE, and apolipoprotein AI levels in patients with chronic hepatitis in the observation group($ \bar x \pm s $)
病情严重程度 血清抗-HBC(log10PEIU/mL) CHE(kU/L) 载脂蛋白AI(mg/dL) 慢性肝炎轻度(n = 52) 2.13 ± 0.35 9.36 ± 2.62 117.02 ± 2.78 慢性肝炎中度(n = 56) 3.39 ± 0.68a 6.82 ± 1.68a 113.09 ± 2.51a 慢性肝炎重度(n = 50) 4.52 ± 0.73ab 3.69 ± 1.83ab 110.02 ± 2.35ab F 195.636 95.114 96.410 P < 0.001* < 0.001* < 0.001* *P < 0.05。与慢性肝炎轻度组比较,aP < 0.05;与慢性肝炎中度比较,bP < 0.05;与慢性肝炎重度比较,cP < 0.05。 表 3 观察组不同疾病类型患者血清抗-HBC、CHE、载脂蛋白AI检测阳性例数比较 [n(%)]
Table 3. Comparison of the number of cases of positive serum anti-HBC, CHE, and ApoAI tests in patients with different disease types in the observation group [n(%)]
疾病类型 血清抗-HBC阳性 CHE(kU/L)阳性 载脂蛋白AI阳性 慢性肝炎轻度(n = 52) 17(32.69) 4(7.69) 13(25.00) 慢性肝炎中度(n = 56) 21(37.50) 10(17.86) 17(30.36) 慢性肝炎重度(n = 50) 45(90.00)ab 45(90.00)ab 40(80.00)ab 肝硬化(n = 166) 142(85.54)ab 151(90.96)ab 147(88.55)ab 肝癌(n = 64) 48(73.85)ab 58(90.63)ab 42(65.63)ab 与慢性肝炎轻度组比较,aP < 0.05;与慢性肝炎中度比较,bP < 0.05。 表 4 观察组肝硬化不同分级患者血清抗-HBC、CHE、载脂蛋白AI水平($ \bar x \pm s $)
Table 4. Serum anti-HBC, CHE, and apolipoprotein AI levels in patients with different grades of cirrhosis in the observation group($ \bar x \pm s $)
不同分级 血清抗-HBC(log10PEIU/mL) CHE(kU/L) 载脂蛋白AI(mg/dL) 肝硬化A级(n = 60) 3.32 ± 0.33 5.06 ± 1.01 180.03 ± 10.17 肝硬化B级(n = 56) 5.39 ± 0.41a 3.29 ± 1.27a 130.01 ± 11.37a 肝硬化C级(n = 50) 6.15 ± 0.39ab 2.22 ± 0.78ab 100.30 ± 12.37ab F 850.166 104.203 709.973 P < 0.001* 0.013* < 0.001* *P < 0.05。与肝硬化A级比较,aP < 0.05;与肝硬化B级比较,bP < 0.05。 -
[1] Ortiz B L,Navarro E K,Rodríguez M A,et al. Occult hepatitis B virus infection in hepatic diseases and its significance for the WHO’s elimination plan of viral hepatitis[J]. Pathogens,2024,13(8):662-662. [2] August M O,Sonali P. Viral hepatitis: Past,present,and future[J]. World Journal of Gastroenterology,2022,28(14):1405-1429. doi: 10.3748/wjg.v28.i14.1405 [3] 李小侠. 血清谷氨酸脱氢酶与其他肝功能指标联合检测在肝病诊断中的临床意义[J]. 陕西医学杂志,2020,49(12):1677-1680. [4] 刘书宏,梁尘格,向毅,等. 慢性乙型肝炎患者血清白介素17A和胆碱酯酶的表达及临床意义[J]. 现代生物医学进展,2019,19(20):3959-3962. [5] 于德敏,张欣欣. 血清HBsAg定量检测在慢性乙型肝炎临床诊疗中的应用及其意义[J]. 临床肝胆病杂志,2019,35(10):2150-2155. [6] 高颖. 载脂蛋白AI和B在脂肪肝中的调节作用[J]. 安徽农业科学,2020,48(12):86-87. [7] 中华医学会健康管理学分会, 中华医学会肝病学分会, 中华医学会检验医学分会. 病毒性肝炎健康管理专家共识(2021年)[J]. 中华健康管理学杂志,2021,15(4):323-331. [8] 谢诗桐. 基于方法对比的中国一般人群健康效用积分体系构建研究—以六维健康调查简表第二版(SF-6Dv2)为例 [D]. 天津: 天津大学, 2020. [9] 赵晓岚,杨颖楠,李晓. 不同Child-Pugh分级肝硬化患者凝血功能指标变化的临床意义[J]. 微量元素与健康研究,2024,41(2):15-16. [10] 李飞飞,张春阳. 慢性乙型病毒性肝炎肝硬化患者病情严重程度及预后研究[J]. 实用医技杂志,2024,31(7):493-497. [11] 张云颖,关霞,任小平. 病毒性肝炎-肝硬化-原发性肝癌病因形态学及防治策略的研究进展[J]. 癌症进展,2021,19(17):1745-1748. [12] 管仲阳,孙立信,祁耀. 2005—2020年盐城市丙型病毒性肝炎的流行病学特征分析[J]. 现代预防医学,2022,49(7):1181-1184,1216. [13] Baudi I,Inoue T,Tanaka Y. Novel biomarkers of hepatitis B and hepatocellular carcinoma: Clinical significance of HBcrAg and M2BPGi[J]. Int J Mol Sci,2020,21(3):949. doi: 10.3390/ijms21030949 [14] 胡海石,董博,王德景,等. 乙型肝炎病毒大蛋白检测在慢性乙型肝炎诊疗中的临床意义[J]. 中西医结合肝病杂志,2020,30(3):205-207. [15] 徐尧,冯静云,郑立明,等. 失代偿期肝硬化合并腹腔感染患者的临床特征及预后影响因素分析[J]. 中国感染与化疗杂志,2023,23(3):313-317. [16] 刘天晨,徐华,雷宇,等. 新型口服抗凝剂和传统抗凝剂在需要抗凝治疗的肝硬化患者中的疗效与安全性比较[J]. 中华肝脏病杂志,2022,30(6):598-605. [17] 渠畅. 肝硬化患者血清脂类及载脂蛋白变化的临床意义 [D]. 济南: 山东大学,2020. [18] 施国美,祝忠良. 常见生化检测指标在原发性胆汁性肝硬化中的临床意义[J]. 中国卫生检验杂志,2020,30(11):1320-1321. [19] 赵伟,陈艳清,季媛媛,等. 早期诊断急性乙型肝炎的新指标: 抗HBc-IgM/HBV DNA定量log值[J]. 肝脏,2022,27(6):655-657. [20] 高晓霞,胡晓波. 生化免疫指标检测在乙型肝炎病情预判中的准确性及临床意义[J]. 陕西中医,2021,42(S01):17-18. [21] 张欢,李小安,刘华柱,等. 血清PA ChE和TBA水平与肝硬化门静脉高压伴上消化道出血的关系[J]. 河北医学,2022,28(1):47-51. [22] 杨建波,石睿,马欢,等. 肝硬化患者血清前白蛋白,血清胆碱酯酶和总胆汁酸水平检测的临床意义[J]. 西部医学,2022,34(7):1006-1010. [23] 卢燕辉,徐成润,卢秋燕,等. 乙型肝炎病毒与载脂蛋白B关系及其意义的实验研究[J]. 中国临床研究,2019,32(1):39-42. [24] 常凤霞,马晓莉,毛迪,等. 慢性丙型肝炎患者载脂蛋白L1基因突变检测[J]. 长春中医药大学学报,2021,37(1):123-125. [25] 徐飞,汪光海,邱伟. 肝癌手术前后血清甲胎蛋白和白蛋白及载脂蛋白水平的变化及意义[J]. 中国肿瘤临床与康复,2021,28(9):1107-1110. [26] 孔玉萍,朱素楠,魏明慧. 血脂、载脂蛋白及凝血功能与慢性病毒性肝炎肝组织纤维化程度的相关性研究[J]. 四川生理科学杂志,2024,46(5):1014-1016,1052. [27] 张映华, 古晓娟. CHE、ALB、CHO在肝炎肝硬化患者中的表达及诊断效能影响研究[J]. 标记免疫分析与临床,2020,27(3):497-501.