發(fā)布時間：2018-06-29 14:09

  本文選題：細胞間粘附分子-1 + 乙肝相關(guān)性肝病��； 參考：《重慶醫(yī)科大學》2013年碩士論文

【摘要】：第一部分sICAM-1在乙肝相關(guān)性肝病發(fā)病中作用的初步研究 目的：通過檢測乙肝相關(guān)性肝病患者血清可溶性細胞間粘附分子-1（Soluble intercellular adhesion molecule-1，sICAM-1）的水平，探討sICAM-1在乙肝相關(guān)性肝病發(fā)病中的作用。 方法：選擇慢性乙型肝炎、乙型肝炎肝硬化及肝衰竭患者各30例，另選擇健康獻血員30例作對照組，應用酶聯(lián)免疫吸附法（Enzyme-1inked immunosorbent assay，ELISA）檢測血清sICAM-1的水平。 結(jié)果：慢性乙型肝炎、乙型肝炎肝硬化、肝衰竭患者血清sICAM-1水平較正常對照組均明顯升高(P=0.029，P=0.00007，P=0.0001)，并與丙氨酸氨基轉(zhuǎn)移酶(Alanine aminotransferase，ALT)、天門冬氨酸氨基轉(zhuǎn)移酶(Aspartate aminotransferase，AST)及總膽紅素(Total bilirubin，TBIL)呈正相關(guān)（ALT：r=0.240，P=0.023；AST：r=0.225，P=0.033；TBIL：r=0.262，P=0.013），與白蛋白（Albumin，ALB）、凝血酶原活動度（Prothrombin activity，PTA）呈負相關(guān)（ALB：r=-0.297，P=0.005；PTA: r=-0.218，P=0.039）。 結(jié)論：sICAM-1可能參與了乙型肝炎免疫損傷過程，并可能在肝纖維化、肝硬化形成過程中發(fā)揮重要作用。檢測乙肝相關(guān)性肝病患者血清sICAM-1水平對判斷患者病情有一定臨床意義。 第二部分粘附分子與聚乙二醇干擾素-α-2a抗乙肝病毒治療應答關(guān)系的初步研究 目的：探討血清可溶性細胞間粘附分子-1（Soluble intercellularadhesion molecule-1， sICAM-1）、血管細胞粘附分子-1(Solublevascuolar cell adhesion molecule-1，sVCAM-1)、E-選擇素（SolubleE-selectin，sE-selectin）、L-選擇素（Soluble L-selectin，sL-selectin）等粘附分子水平與聚乙二醇干擾素-α-2a (Pegylated interferonalpha-2a,PegIFN-α-2a)治療慢性乙型病毒性肝炎（Chronic hepatitis B，CHB）病毒學應答的關(guān)系。 方法：納入32例CHB患者（基因型檢測均為B型），均接受PegIFN-α-2a180μg每周1次治療，于首次PegIFN-α-2a治療前及治療后12周、24周采血。另選擇健康獻血員30例作對照組，采用酶聯(lián)免疫吸附法（Enzyme-1inked immunosorbent assay，ELISA）檢測血清sICAM-1、sVCAM-1、sE-selectin、sL-selectin。 結(jié)果：CHB患者治療前sICAM-1、sVCAM-1、sE-selectin、sL-selectin水平明顯高于對照組（p均0.00001）；PegIFN-α-2a治療應答組患者治療前sICAM-1、sVCAM-1、sE-selectin、sL-selectin水平明顯高于無應答組患者（PI=0.001，PV=0.002，PE=0.02，PL=0.004），治療后各階段血清sICAM-1、sVCAM-1、sE-selectin、sL-selectin水平均明顯下降PI=0.0001，PV=0.00004，PE=0.002，，PL=0.0004；PI=0.00007，PV=0.00001，PE=0.0003，PL=0.00003；而無應答組治療前后血清sICAM-1、sVCAM-1、sE-selectin、sL-selectin水平比較差異無顯著性（P均0.05）。 結(jié)論：sICAM-1、sVCAM-1、sE-selectin、sL-selectin可能作為預測PegIFN-α-2a治療CHB患者療效的有效指標。
[Abstract]:Part I the role of sICAM-1 in the pathogenesis of hepatitis B associated liver disease objective: to detect the level of soluble intercellular adhesion molecule-1 (sICAM-1) in serum of patients with hepatitis B associated liver disease. To investigate the role of sICAM-1 in the pathogenesis of hepatitis B related liver disease. Methods: 30 patients with chronic hepatitis B, 30 patients with cirrhosis of hepatitis B and 30 patients with liver failure were selected as control group. The serum levels of sICAM-1 were detected by Enzyme-1inked immunosorbent assay-linked immunosorbent assay (Elisa). Results: chronic hepatitis B, hepatitis B cirrhosis, The serum levels of sICAM-1 in patients with liver failure were significantly higher than those in the control group (P0.029 / P0.00007 / P0. 0001), and were positively correlated with Alanine aminotransferase (alt), Aspartate aminotransferase (AST) and total bilirubin (TBIL). There was a negative correlation between TBI: r ~ (0.262) and Albumin (ALB) and prothrombin activity (PTA) (ALB: r ~ (-0.297) P _ (0.005) P _ (TAA): r ~ (-0.218N) P _ (0.039). ConclusionsICAM-1 may be involved in the process of hepatitis B immune injury, and may play an important role in the process of liver fibrosis and cirrhosis. Detection of serum sICAM-1 level in patients with hepatitis B-associated liver disease has certain clinical significance. Part two the relationship between adhesion molecules and the antiviral response of polyethylene glycol interferon-偽-2a objective: to investigate the relationship between serum soluble intercellularadhesion molecule-1 (sICAM-1) and vascular cell adhesion molecule 1 (Soluble cell adhesion molecule cell adhesion) The relationship between the levels of adhesion molecules such as Soluble L-selectin (Soluble L-selectin) and Pegylated interferon- 偽 -2a (PegIFN- 偽 -2a) in the treatment of chronic viral hepatitis B (CHB). Methods: 32 CHB patients (genotype B) were treated with PegIFN- 偽 -2a 180 渭 g once a week. Blood samples were collected before and after the first treatment of PegIFN- 偽 -2a. 30 healthy blood donors were selected as control group. The serum sICAM-1sVCAM-1 and sE-selectinsL-selectinin were detected by Enzyme-1inked immunosorbent Assay Elisa. 緇撴灉錛欳HB鎮(zhèn)ｈ

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