The Research Of FGL2 Thrombinase In Liver Tissue Of Patients With Severe Hepatitis B During Convalescence

Objective:Through observing the expression of FGL2 prothrombinase and HBVDNA in liver tissue of patients with severe hepatitis B during recovery period,and to analyze the expression of FGL2 prothrombinase and the pathological changes of the liver,liver function,prothrombin activity(PTA),HBVDNA in liver tissue and serum HBVDNA,and to explore the role of FGL2 prothrombinase in the pathogenesis and progression of severe hepatitis B,and to understand the clinical significance of FGL2 prothrombinase expression assay.Methods:(1)According to the diagnostic criteria for severe hepatitis,"2012 edition of liver failure diagnosis and treatment guidelines" and chronic hepatitis B diagnostic criteria "2015 edition of chronic hepatitis B prevention and treatment guidelines",collected 57 cases of hepatitis B patients,including severe hepatitis B patients with convalescence 38 cases of the study group(according to the patient liver histopathological results will be divided into three groups of non-cirrhosis of the study group,cirrhosis of the study group 2);19 cases of chronic hepatitis B patients as the control group(according to the patient liver histopathological results Mildly divided into control group 1,moderate to severe control group 2).(2)Liver biopsy was performed by B-ultrasonography.Pathological sections of liver tissues were taken with HE and FGL2 immunohistochemistry was performed.To observe the intensity of FGL2 positive cells,that is,to select yellow,brown and tan staining as the standard,select the representative high-power field(×200)on each slice,and then the degree of staining and positive Cell area to determine the results.(3)HBVDNA was extracted from the liver tissue of paraffin sections by salting out,and the expression of HBVDNA and HBVDNA were detected by real-time fluorescence quantitative PCR.(4)The AU-640 automatic biochemical analyzer was used to detect the liverfunction: the levels of serum total bilirubin(TBiL),alanine aminotransferase(ALT)and aspartate aminotransferase(AST)The expression of prothrombin activity(PTA)was detected by STAGO automatic hemagglutination analyzer.(5)The difference of FGL2 and HBVDNA expression in liver tissue between the study group and the control group and the study group was analyzed by SPSS 17.0software,and the expression of FGL2 Expression and liver disease,liver function,PTA,liver tissue HBVDNA and serum HBVDNA correlation.Results:(1)The pathological features of liver tissue was equivalent to inflammation grade(G)and fibrosis staging(S)in the study group(severe hepatitis B recovery period)were 30 cases of severe hepatitis B recovery group(study group 1)without cirrhosis(26.73%),S2(3 cases),S3(10%),S3(3)5 cases(16.67%),S4 15 cases(50%).9 cases(37.5%),3 cases of G3(37.5%)and 2 cases of G4(25%)were treated with 8 cases of severe hepatitis B recovery group(study group 2)with cirrhosis.It is suggested that equivalent to G3-4S3-4 is the main liver tissue in the recovery stage of severe hepatitis B,and there is obvious hepatic fibrosis after necrosis,or cirrhosis after necrosis,and inflammation and fibrosis of liver tissue are also manifested.The control group(chronic hepatitis B)was diagnosed as mild in 10 cases(control group1);moderate to severe 9 cases(control group 2).(2)The expression of FGL2 in liver tissue of each group was 29 cases(96.67%)and 1(3.33%)of the patients with severe hepatitis B without liver cirrhosis(group 1)Negative expression,the positive expression were: 9 cases(30%)weak positive,5cases(16.67%)moderate positive,15 cases(50%)strong positive.There was moderate positive expression in severe hepatitis B recovery group(study group 2)and chronic moderate to severe hepatitis B group(control group 2)with cirrhosis.The positive expression was positive in 1 case(12.5%)and 7(87.5%)were positive.The positive expression of the two groups was positive in 5 cases(55.56%)and 4 cases(44.44%)were positive.In the chronic mild hepatitis B group(control group 1)was negative to weakly positive expression,7 cases(70%)were weakly positive and 3(30%)were negative.(3)The average score of FGL2 expression in liver tissue was 7.47±4.18 in the study group and 4.11±4.51 in the control group,the difference was statistically significant(P=0.007,P<0.01).The expression of FGL2 in the study group was higher than that in the control group,which indicated that the expression of FGL2 in the liver tissue of the patients with severe hepatitis B was stronger than that of the chronic hepatitis B group,suggesting that the recovery of severe hepatitis B Hepatocellular inflammation is more severe than chronic hepatitis B.(4)The average expression of FGL2 in liver tissue was 6.47±4.03(study 1),11.25±2.12(study 2),0.80±0.63(control group 1),7.78±4.06(Control group 2).The expression of FGL2 was significantly different between the two groups(P <0.01).1)The difference between the two groups was statistically significant(P=0.001,P<0.01).The mean score of the study group 1 was lower than that of the study group2,indicating that the expression of FGL2 in the liver tissue of the patients with severe hepatitis B without cirrhosis was weaker than that of the patients with severe hepatitis B with cirrhosis.Suggesting that liver cirrhosis of severe hepatitis in the recovery of hepatocellular inflammation necrosis is less than cirrhosis of severe hepatitis B recovery period.2)The difference between the two groups was statistically significant(P<0.01).The mean score of the study group 1 was higher than that of the control group,indicating that the expression of FGL2 in liver tissue of patients with severe hepatitis B without cirrhosis was stronger than that of chronic mild hepatitis B group.Suggesting that cirrhosis of severe hepatitis in the recovery of hepatocellular inflammation necrosis than chronic mild hepatitis B.3)There was no significant difference between the two groups(P=0.191,P>0.05).The mean score of the study group 1 was similar to that of the control group 2,which indicated that the expression of FGL2 in liver tissue of patients with severe hepatitis B without cirrhosis was similar to that of chronic moderate to severe hepatitis B group.Suggesting that liver cirrhosis of severe hepatitis in the recovery of hepatocellular inflammation and necrosis and chronic moderate to severe hepatitis B similar.4)The difference between the two groups was statistically significant(P<0.01).The mean score of the two groups was higher than that of the control group(1),which indicated that the expression of FGL2 in the liver tissue of the patients with cirrhosis was higher than that in the mild hepatitis B group.Suggesting that cirrhosis of severe hepatitis in the recovery of liver cell inflammation and necrosis than chronic mild hepatitis B.5)The difference between the two groups was statistically significant(P=0.021,P<0.05).The mean score of the two groups was higher than that of the control group2,which indicated that the expression of FGL2 in the liver tissue of the patients with cirrhosis was higher than that in the chronic hepatitis B group.Suggesting that cirrhosis of severe hepatitis in the recovery of hepatocellular inflammation and necrosis than chronic moderate to severe hepatitis B.(5)The mean value of HBVDNA expression in liver tissue was 1.95±1.18 in the study group and 4.79±1.49 in the control group,the difference was statistically significant(P=0.041,P<0.05).The mean value of the study group was lower than that of the control group,which indicated that the expression of HBVDNA in the liver tissue of the patients with severe hepatitis B was lower than that of chronic hepatitis B,which indicated that the degree of hepatitis HBV replication was lower in chronic hepatitis B than in chronic hepatitis B.(1),4.18±1.07(study 2),4.70±1.84(control group 1),and the number of HBVDNA expression in liver tissue was(3.83±1.21)4.88±1.08(control group 2).The rats in the study group were compared with the control group 2,the control group1 and the control group.The two groups were compared with the control group 1 and the control group.The difference between the two groups was statistically significant(P=0.038,P<0.05).The mean value of expression in group 1 was lower than that in control group 2,indicating that HBVDNA expression in patients with severe hepatitis B without cirrhosis was lower than that in chronic moderate to severe hepatitis B group.Suggesting that liver cirrhosis of severe hepatitis B recovery of liver cell HBV replication less than chronic moderate to severe hepatitis B.There was no statistically significant difference between the other groups(P> 0.05).(7)The mean score of FGL2 expression in hepatic tissue of patients with severe hepatitis B was analyzed by Spearman correlation analysis of TBiL,ALT,AST,PTA,HBVDNA and HBVDNA,and the correlation coefficients were not statistically(P>0.05).Conclusion:In the recovery stage of severe hepatitis B,G3-4S3-4 is the main liver tissue,and there is obvious hepatic fibrosis after necrosis,and inflammation and fibrosis of liver tissue are manifested at the same time,and there is cirrhosis after necrosis.Liver tissue FGL2 expression of severe hepatitis B recovery period is higher than chronic hepatitis B;no cirrhosis of severe hepatitis B recovery period is lower than cirrhosis of severe hepatitis B recovery period,and with chronic Severe hepatitis B is similar to the recovery of severe hepatitis B in patients with cirrhosis higher than chronic moderate to severe hepatitis B;severe hepatitis B recovery period is higher than chronic mild hepatitis B.Indicating that the expression of FGL2 prothrombinase in liver tissue is not unique to severe hepatitis.FGL2 is strongly expressed in the recovery period of severe hepatitis B and is positively correlated with cirrhosis after necrosis.Heavy hepatitis B condition improved and expression decreased.The expression of HBVDNA in hepatocellular carcinoma was lower than that in chronic moderate to severe hepatitis B in the recovery period of severe hepatitis B without cirrhosis,suggesting that the degree of hepatitis HBV replication in patients with severe hepatitis B was lower than that in chronic moderate to severe hepatitis B.Therefore,the expression of FGL2 prothrombinase in human liver tissue is expected to be a monitoring index in the development of severe hepatitis B.It can indirectly reflect the degree of necrosis or repair of hepatocytes,provide a new way for prevention and treatment of severe hepatitis and method.