本文選題：高爾基體蛋白73 + 乙型肝炎病毒　； 參考：《重慶醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的：探討血清高爾基體蛋白73（Golgi Protein73, GP73）在慢性乙型肝炎病毒(Hepatitis B virus，HBV)感染所致的不同類型的慢性肝病患者血清中的表達(dá)水平及其臨床意義。 方法：收集177份各類HBV相關(guān)性慢性肝病患者血清與45份健康對照組血清，其中包括17例HBV攜帶者、70慢性乙型肝炎（chronichepatits B, CHB)、57例肝硬化(liver cirrhosis, LC)、33例肝細(xì)胞癌(hepatocellular carcinoma, HCC)患者。分別采用酶聯(lián)免疫吸附法(enzyme-linked immunosorbent assay, ELISA)對血清GP73進(jìn)行定量檢測，生化分析儀檢測ALB、TB、DB、ALT、AST、ALP、GGT的含量，電化學(xué)發(fā)光法測定AFP，化學(xué)發(fā)光法檢測HA、LN、PIIINP、CIV，實時熒光定量PCR檢測HBV DNA，全自動凝血分析儀測定PT、PTA。采用SPSS17.0統(tǒng)計軟件進(jìn)行統(tǒng)計學(xué)分析；運用Spearman相關(guān)性分析法分析GP73與其他檢測指標(biāo)間的相關(guān)性。 結(jié)果：1.各組血清GP73表達(dá)水平由高到低分別為：HCC組1561.741±11.912ng/L，，CHB組700.756±19.337ng/L，LC組675.294±32.761ng/L，均顯著高于健康對照組（558.853±5.883ng/L）或HBV攜帶者組（563.803±11.197ng/L）(P值均＜0.01)；HBV攜帶者組與健康對照組間無顯著性差異（P=0.646）。 2. CHB各亞組血清GP73表達(dá)水平由高到低為：中度CHB亞組716.178±19.127ng/L，重度CHB亞組704.632±15.389ng/L，均顯著高于輕度CHB亞組（688.751±10.114ng/L）(P值均＜0.01)；而中度CHB亞組與重度CHB亞組間無顯著性差異（P=0.104）。CHB患者血清中HBV DNA載量與GP73水平呈正相關(guān)（r=0.438，P＜0.001）。 3.肝硬化代償期亞組患者血清GP73水平（702.406±16.178ng/L)較失代償期亞組(661.738±30.511ng/L)顯著高(P=0.02)。 4. AFP陰性HCC亞組患者血清GP73水平(1562.550±13.964ng/L)較AFP陽性HCC亞組(1561.070±10.269ng/L)無顯著性差異（P=0.727）。 5.將各不同病程患者血清GP73與肝功能、凝血功能、AFP、肝纖維譜及HBV DNA定量等指標(biāo)進(jìn)行Spearman相關(guān)分析，結(jié)果顯示：在HBV攜帶者組GP73與ALB呈負(fù)相關(guān)（r=-0.946，P＜0.01）；在CHB組GP73與ALB、PTA呈負(fù)相關(guān)（r=-0.816，-0.430，P均＜0.01），與TB、DB、ALT、AST、ALP、GGT、PT、HA、PIIINP、CIV、lgDNA等指標(biāo)呈正相關(guān)(r=0.609,0.633,0.330,0.373,0.321,0.441,0.468,0.423,0.278,0.274,0.438,P均＜0.05)；在LC組GP73與ALP、GGT、PT、HA、CIV呈正相關(guān)（r=0.368,0.382,0.382,0.330,0.383，P均＜0.05）；在HCC組GP73與ALB呈負(fù)相關(guān)（r=-0.858,P＜0.01），與TB、DB、ALT、AST、AFP、lgDNA呈正相關(guān)（r=0.936,0.945,0.693,0.456,0.250,0.434，P均＜0.05）。 結(jié)論：1.首次探討了慢性HBV感染所致CHB、LC、HCC、HBV攜帶者各組間、各亞組間患者血清GP73表達(dá)水平差異性。 2. CHB、LC患者血清GP73高水平表達(dá)提示肝臟健存肝細(xì)胞的功能、結(jié)構(gòu)損傷較重，肝纖維化程度亦較重。 3.慢性HBV感染者血清GP73高水平表達(dá)還與HBV DNA載量增高及其導(dǎo)致肝細(xì)胞免疫學(xué)損傷加重相關(guān)。 4.在HCC患者，血清GP73高水平表達(dá)可作為AFP陰性者的診斷指標(biāo)。
[Abstract]:Objective: To investigate the expression level and clinical significance of serum Golgi Protein73 (Golgi Protein73, GP73) in the serum of chronic hepatitis B patients with chronic hepatitis B virus (Hepatitis B virus, HBV) infection.
Methods: the serum of 177 patients with HBV related chronic liver disease and 45 healthy controls were collected, including 17 HBV carriers, 70 chronic hepatitis B (chronichepatits B, CHB), 57 cirrhosis (liver cirrhosis, LC), 33 cases of hepatocellular carcinoma (hepatocellular carcinoma, HCC). The enzyme linked immunosorbent assay (enzyme) was used respectively. -linked immunosorbent assay, ELISA) the quantitative detection of serum GP73, biochemical analyzer to detect ALB, TB, DB, ALT, AST, ALP, GGT content, electrochemiluminescence detection, real-time fluorescence quantitative detection, statistical software for statistics Spearman correlation analysis was used to analyze the correlation between GP73 and other test indexes.
Results: 1. the levels of serum GP73 expression from high to low were 1561.741 + 11.912ng/L, 700.756 + 19.337ng/L in group CHB and 675.294 + 32.761ng/L in group LC, which were significantly higher than those in the healthy control group (558.853 + 5.883ng/L) or HBV carrier group (563.803 + 11.197ng/L) (P < 0.01). There was no significant difference between the HBV carrier group and the healthy control group. Differences (P=0.646).
The levels of serum GP73 expression in 2. CHB subgroups were from high to low: moderate CHB subgroup 716.178 + 19.127ng/L, severe CHB subgroup 704.632 + 15.389ng/L, which were significantly higher than those in mild CHB subgroup (688.751 + 10.114ng/L) (P < 0.01), but there was no significant difference between the moderate CHB subgroup and the severe CHB subgroup (P=0.104) There was a positive correlation between the 3 levels (r=0.438, P < 0.001).
3. the level of serum GP73 (702.406 + 16.178ng/L) in compensatory subgroup of liver cirrhosis was significantly higher than that in decompensated subgroup (661.738 + 30.511ng/L) (P=0.02).
There was no significant difference in serum GP73 level (1562.550 + 13.964ng/L) between 4. AFP negative HCC subgroup and AFP positive HCC subgroup (1561.070 + 10.269ng/L) (P=0.727).
5. the serum GP73 of patients with different course of disease and liver function, coagulation function, AFP, liver fiber spectrum and HBV DNA were analyzed by Spearman. The results showed that the GP73 in the HBV carrier group was negatively correlated with ALB (r=-0.946, P < 0.01). HA, PIIINP, CIV, lgDNA are positively correlated (r=0.609,0.633,0.330,0.373,0.321,0.441,0.468,0.423,0.278,0.274,0.438, P < 0.05), and GP73 in LC group is positively correlated with ALP, GGT, PT, HA. Positive correlation (r=0.936,0.945,0.693,0.456,0.250,0.434, P < 0.05).
Conclusion: 1.. For the first time, the difference of serum GP73 expression among CHB, LC, HCC, HBV carriers in different groups of patients with chronic HBV infection was discussed.
2. the high level of serum GP73 expression in patients with CHB and LC suggests that the liver has the function of protecting the liver cells, the structural damage is heavier, and the degree of liver fibrosis is heavier.
3. the high level of serum GP73 expression in chronic HBV infection is also related to the increase of HBV DNA load and the aggravation of liver cell immune injury.
4. in patients with HCC, the high level of serum GP73 expression can be used as a diagnostic marker for AFP negative patients.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R512.62

【參考文獻(xiàn)】

相關(guān)期刊論文 前3條

1 黃玉波;李鑫;喬雍;常路絲;肖凡;魏紅蓮;張仁雯;成軍;魏紅山;;N-糖基化修飾蛋白gp73與肝硬化患者Child-Pugh的關(guān)系[J];胃腸病學(xué)和肝病學(xué)雜志;2011年04期

2 中華醫(yī)學(xué)會傳染病與,寄生蟲病學(xué)分會,肝病學(xué)分會;病毒性肝炎防治方案[J];中華肝臟病雜志;2000年06期

3 鄭建建;錢瓊信;王斯璐;丁賽丹;俞富軍;陳必成;;慢性乙型肝炎患者血清GP73與肝纖維化的相關(guān)性[J];中國衛(wèi)生檢驗雜志;2012年02期

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