| Cirrhosis is the final result of chronic liver diseases. There are many reasons for the cause of cirrhosis. In our country it was found mainly in chronic viral hepatitis, this kind of Cirrhosis is called posthepatitic cirrhosis. At least over 2/3 of the cirrhosis in our country is posthepatitic cirrhosis, among them hepatitis B cirrhosis account for 78.8% of posthepatitic cirrhosis. As everyone knows, our country is a highly infected B-mode hepatitis virus area, where there are about 170 million patients with hepatitis B virus infection, about 25-40% of whom will die of cirrhosis finally. Therefore, it is of great significance to study the severity and prognostic evaluation of hepatitis B cirrhosis.Objective:In this study, we intent to detect the level of serum sP-selectin and sICAM-1 in patients with hepatitis B cirrhosis and to investigate the correlation between sP-selectin and sICAM-1 and their correlation with ALT and HBV DNA. Then it shows the relationships of sP-selectin and sICAM-1 with carcinogenesis,progression and prognosis of hepatitis B cirrhosis. The result may provide new theoretical basis for the treatment of hepatitis B cirrhosis. Method:Serum specimens were obtained from 66 patients who visited digestive department, the second affiliated hospital of Hebei Medical University between March and November, 2007, including 20 healthy people as normal controls, 22 patients with stationary cirrhosis, 24 patients with active cirrhosis. According to the child-Pugh scores standard, the experimental groups include 12 patients with child-Pugh A cirrhosis, 16 patients with child-Pugh B cirrhosis and 18 patients with child-Pugh C cirrhosis. We drew fasting venous blood, added 3ml venous blood into a tube, centrifugalized at 3℃, 2000r/min for 15minutes, and then collected the serum specimen and storaged it in frige at -80℃. According to assay procedure in the introduction of enzyme-linked immunosorbent assay kit, we dispensed 100ul of standards and samples into the appropriation microtitre wells, read the optical density with a microtiter plate reader, constructed a standard curve by plotting the mean absorbance obtained for each reference standard against its concentration in ul/ml on linear graph paper. The concentration for each sample was determined by the corresponding mean absorbance value. The experimental data was shown as mean±standard deviation ( X±S), the statistical method was ANOVA and linear correlation.Results:1.The detection of serum sP-selectin and sICAM-1 in normal controls: The mean level of sP-selectin was (6.23±2.59), and the mean level of sICAM-1was (90.60±19.33).2.The detection of serum sP-selectin in stationary cirrhosis group and active cirrhosis group:The mean level of serum sP-selectin in stationary cirrhosis group was (10.01±4.52), the mean level of that in active cirrhosis group was (13.43±5.74). The mean level of serum sP-selectin in active cirrhosis group was higher than that in stationary cirrhosis group. The mean levels of that in all of the two groups were significantly higher than that in normal controls (P<0.05).3.The detection of serum sICAM-1 in stationary cirrhosis group and active cirrhosis group:The mean level of serum sICAM-1 in stationary cirrhosis group was (159.58±61.16). The mean level of that in active cirrhosis group was (229.66±103.35). The mean level of serum sICAM-1 in active cirrhosis group was significantly higher than that in stationary cirrhosis group. The mean levels in all of the two groups were higher than that in normal controls (P<0.05).4.The detection of serum sP-selectin in the three child-Pugh classification groups:The mean level of serum sP-selectin in Child-Pugh A cirrhosis group (group A) was (7.28±1.67), the mean level of that in Child-Pugh B cirrhosis group (group B) was (10.96±3.65), and the mean level of that in Child-Pugh C cirrhosis group (group C) was (15.43±5.55). The mean level of that in group C was significantly higher than that in group A and group B, the mean level in group B was higher than that in group A (P<0.05).5.The detection of serum sICAM-1 in the three child-Pugh classification groups:The mean level of serum sICAM-1 in group A was (154.35±49.97), the mean level of that in group B was (187.89±65.60), and the mean level of that in group C was (249.11±109.63). The mean level of that in group C was significantly higher than that in group A and group B, the mean level in group B was higher than that in group A (P<0.05).6.The detection of serum sP-selectin,sICAM-1 in the HBV DNA-positive (HBV DNA>4×103) and HBV DNA -negative (HBV DNA<4×103) cirrhosis groups:In the HBV DNA-positive cirrhosis group, the mean level of serum sP-selectin was (11.51±4.76), and the mean level of serum sICAM-1 was (194.71±92.99). In the HBV DNA–negative cirrhosis group, the mean level of serum sP-selectin was (12.75±6.69), and the mean level of serum sICAM-1 was (187.52±99.16), but there was no significant difference between the two groups (P>0.05).7.In patients with hepatitis B cirrhosis, there was a positive correlation between sP-selectin and sICAM-1 (r=0.758, P<0.05), there was a positive correlation between sICAM-1 and ALT (r=0.397, P<0.05), there was no correlation between sP-selectin and ALT (r=0.218,P>0.05). In normal controls, there were no correlations between sP-selectin, sICAM-1 and ALT (P>0.05).Conclusions:1.The levels of serum sP-selectin and sICAM-1 in patients with hepatitis B cirrhosis were significantly higher than those in control groups, it is suggested that the decrease of the liver inactivation, secondary endotoxaemia and the activation of endothelial cell and inflammatory cell might induced the increase of serum P-selectin and ICAM-1.2.The levels of serum sP-selectin and sICAM-1 in patients with active cirrhosis were increased greatly, it showed that both of them participated in the inflammation reaction and immune injury in people with hepatitis B cirrhosis.3.There was significant increase of serum sP-selectin and sICAM-1 in patients with Child-Pugh C cirrhosis, it showed a law of Child-Pugh A>Child-Pugh B>Child-Pugh C. It indicated that serum sP-selectin and sICAM-1 were related to the severity of hepatitis B cirrhosis. sP-selectin and sICAM-1 are likely to be new indexes for the assessment of hepatic hepatic function.4.The serum sP-selectin level in hepatitis B cirrhosis had a positive correlation with sICAM-1, the changes of serum levels of them were not related to the replication of HBV. It suggested that secondary immune injury lead to expression of sP-selectin and sICAM-1, which promoted the injury of liver. |
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