Clinical Significance Of Detection Of Alpha 1-microglobulin In Serum Of Patients With Chronic Hepatitis B

Background:Chronic hepatitis B(CHB)is an infectious disease caused by hepatitis B virus(HBV)infection,easily chronic,and eventually evolved into cirrhosis and hepatocellular carcinoma.About 400 million people worldwide are chronic HBV carriers,nearly30% of the world's population is infected or has been infected with HBV.In 2006,the epidemiological survey of hepatitis B in China showed that the carrying rate of hepatitis B virus was 7.18% in the general population aged 1~59 years old and0.96% in children under 5 years old.There were about 93 million people with chronic HBV infection,about 20 million patients with chronic hepatitis B people.Early detection of viral hepatitis in patients with liver damage is very important,the current detection of liver function indicators are many,but it is difficult to accurately and objectively reflect the liver function.?1-microglobulin(?1-MG)is a small molecule glycoprotein with relative molecular mass of 26 000 ~ 33 000,which is widely distributed in the body and is mainly composed of hepatocyte-specific synthesis and is distributed to the body Tissue,has an important physiological role.Objective:To explore clinical significance of alpha 1 microglobulin(?1-MG)in the evaluation of liver function in patients with chronic hepatitis B(CHB)through the detection of serum levels of ?1-MG in the chronic hepatitis B patients with different liver function injuries.Total 243 cases of chronic hepatitis B patients were divided into normal liver and renal function group,normal liver function and abnormal renal function group,abnormal liver function and normal renal function group,abnormal liver and renal function group,while 67 cases of healthy persons were selected as control group.The serum ?1-MG levels of the subjects in various groups were measured and the liver function indexes such as alanine aminotransferase(ALT),aspartate transaminase(AST)and alkaline phosphatase(ALP),the renal function indexes such as CREAatinine(CREA),blood urea nitrogen(BUN)were determined at the same time.The ?1-MG level was detected by immune turbidimetry,ALT by ultraviolet lactate dehydrogenase method,AST by UV-malate dehydrogenase method,ALP by amp buffer method,CREAby sarcosine oxidase method and BUN by UV-glutamic acid dehydrogenase method.Methods:Results:Compared with control group,the level of ?1-MG in serum of the patients in abnormal liver function and nomal renal function group was significantly decreateased(P<0.05),the serum ?1-MG levels of the patients in normal liver function and renal function group and abnormal liver and renal function group had no significant changes(P>0.05),and the serum ?1-MG level of the patients in normal liver function and abnormal renal function group was significantly increateased(P<0.01).According ?1-MG <10 mg·L-1 for judging abnormal liver function standards,the positive rate of the patients in abnormal liver function and normal renal function group was 36% and the positive rate was 24% in abnormal liver and renal function group.As to ?1-MG <15 mg·L-1 as the standard,the positive rate in abnormal liver function and normal renal function group was 68%.The serum?1-MG level had negatively correlated with the ALT,AST and ALP of the patients in abnormal liver function and nomal renal function group(r=-0.934,r=-0.916,r=-0.847,P<0.01),and its value decreateased with the severity of liver injury.Conclusion:The level of serum ?1-MG in patients with normal liver and kidney function was slightly lower than that in the normal control group,but there was no significant difference with the control group.The level of serum ?1-MG in normal renal function group was higher than that in the normal control group Serum ?1-MG increateased;abnormal liver function,CHB patients with serum ?1-MG levels according to whether the abnormal renal function and different.There was no significant difference in the level of ?1-MG compared with the control group.If the renal function was normal,the level of ?1-MG was significantly decreateased;?1-MG was negatively correlated with ALT and AST.The positive rate of liver function abnormality was 68%,?1-MG was an effective index for detecting liver function in patients with CHB.However,the clinical application Exclude renal disease damage caused by the results of interference.There was no significant difference in ?1-MG level between HBV DNA low load group and HBV DNA loading group,and ?1-MG level did not appear to be directly related to hepatitis virus infection.