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重症肝炎患者与原发性肝癌患者血清可溶性CD40表达水平研究

作者：周红霞

单位：邯郸市传染病医院肝病科河北邯郸 056001

关键词：可溶性CD40 重症肝炎原发性肝癌临床疗效

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出版年,卷(期):页码：2016,8(4):97-101

摘要：

摘要：目的分析可溶性CD40在重症肝炎患者与原发性肝癌患者血清中的表达及其临床意义。方法
随机选取自2014年12月至2015年8月于邯郸市传染病医院进行治疗的44例重症肝炎治疗患者和26
例原发性肝癌患者为观察组1和观察组2，同时选取本院体检科健康体检者65例为对照组。采用酶
联免疫吸附实验（ELISA）检测血清CD40浓度并比较各组间的差异。结果观察组1患者血清CD40
为（135.85 ± 115.5）pg/ml，观察组2患者血清CD40为（150.95 ± 75.5）pg/ml，对照组血清CD40
为（45.58 ± 28.9）pg/ml，观察组1和观察组2的CD40水平显著高于对照组，组间差异有统计学意义
（t = 5.644，P = 0.0017），观察组1与观察组2患者血清CD40水平差异无统计学意义（t = 0.028，P =
0.476）。重症肝炎患者中病死患者的CD40水平为（200.2 ± 135.6）pg/ml，显著高于存活患者的（85.93 ±
75.2）pg/ml，差异有统计学意义（t = 0.625，P = 0.0017）。重症肝炎患者中肝性脑病患者治疗后血清
CD40水平为（235.9 ± 120.5）pg/ml，高于无肝性脑病患者（108.5 ± 100.8）pg/ml，差异有统计学意义
（t = 5.412，P = 0.0014）。观察组1和观察组2患者可溶性CD40浓度与ALT和AST水平均呈正相关（r =
0.48、0.36，P = 0.01、0.02；r = 0.43、0.40，P = 0.00、0.02）。重症肝炎患者中男性患者可溶性CD40
平均浓度为（225.48 ± 95.52）pg/ml，高于女性患者的（164.25 ± 89.65）pg/ml，差异具有统计学意义
（t = 3.24，P = 0.01）。结论重症肝炎患者与原发性肝癌患者血清中可溶性CD40水平显著高于健康人
群，是评价肝细胞急性损伤和评估重型肝炎预后的免疫学指标。

Abstract: Objective To analyze the expression levels and clinical significance of serum soluble CD40 in
patients with severe hepatitis and primary liver cancer. Methods Total of 44 patients with severe hepatitis
and 26 patients with primary liver cancer from December 2014 to August 2015 in Handan Infectious Disease
Hospital were selected as observation group 1 and observation group 2. Total of 65 cases who underwent
physical examination were selected as control group. Enzyme-linked immunosorbent assay (ELISA) was used
to detect the concentration of serum soluble CD40. Results The serum CD40 levels of patients in observation
group 1 and observation group 2 were (135.85 ± 115.5) pg/ml and (150.95 ± 75.5) pg/ml, respectively, which
were significantly higher than those in control group [(45.58 ± 28.9) pg/ml], the differences were statistically
significant (t = 5.644, P = 0.0017). The difference of serum CD40 level between observation group 1 and
observation group 2 had no statistical significance (t = 0.028, P = 0.476). The level of CD40 in severe hepatitis
patients who died was (200.2 ± 135.6) pg/ml, which was significantly higher than that of survivors
[(85.93 ± 75.2) pg/ml], the difference was statistically significant (t = 0.625, P = 0.0017). The serum
levels of CD40 in patients with hepatic encephalopathy (HE) and non-HE were (235.9 ± 120.5) pg/ml
and (108.5 ± 100.8) pg/ml respectively, the difference was statistically significant (t = 5.412, P = 0.0014).
There was a positive correlation between the concentration of soluble CD40, ALT and AST in observation
group 1 and observation group 2 (r = 0.48, 0.36, P = 0.01, 0.02; r = 0.43, 0.40, P = 0.00, 0.02). The average
concentration of soluble CD40 in male patients with severe hepatitis was (225.48 ± 95.52) pg/ml, which was

higher than that of female patients [(164.25 ± 89.65) pg/ml]. The difference was statistically significant (t = 3.24,
P = 0.01). Conclusions Serum soluble CD40 level in patients with severe hepatitis and primary liver cancer
is significantly higher than that in healthy people. It is an immunological index to evaluate the acute injury of
liver cells and the prognosis of severe hepatitis.

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