摘要
目的初步探讨乙型肝炎肝硬化并发门静脉血栓形成(PVT)患者血清中性粒细胞胞外陷阱(NETs)标志物变化。方法2018年9月~2022年10月我院诊治的乙型肝炎肝硬化患者55例,经医院HIS系统采集病例资料,使用超声检查诊断PVT。;采用ELISA法检测血清髓过氧化物酶(MPO)、中性粒细胞弹性蛋白酶(NE)和瓜氨酸组蛋白H3(CitH3)水平。结果经超声检查,本组发现PVT患者21例(38.2%);PVT组MELD评分、Child C级和脾切除术史占比分别为18.2(17.6,19.5)分、52.4%和42.9%,显著高于非PVT组【分别为13.2(9.3,16.8)分、14.7%和2.9%,差异显著(P<0.05);PVT组血清总胆红素、D-二聚体、中性粒细胞/淋巴细胞比率、MPO、NE和CitH3水平分别为25.6(21.6,36.0)μmol/L、1095.0(532.5,2202.5)ng/ml、2.3(1.9,4.2)、42.4(20.7,78.9)ng/ml、2468.2(1344.8,5620.6)ng/ml和79.2(44.8,126.2)ng/ml,均显著大于非PVT组【分别为18.9(16.5,28.3)μmol/L、390.0(280.0,680.0)ng/ml、1.9(1.2,2.6)、10.8(5.6,16.0)ng/ml、623.5(241.4,1006.3)ng/ml和28.8(10.4,39.6)ng/ml,P<0.05】,而血清白蛋白水平为(31.5±5.8)g/L,显著低于非PVT组【(35.4±5.8)g/L,P<0.05】。结论脾切除手术可能诱发乙型肝炎肝硬化患者发生PVT。术后,可能纠正了血细胞降低,但血清NETs标志物水平升高可能具有一定的提示作用,需要密切随访,以期早期发现和处理。
Objective This study was conducted to investigate the changes of serum neutrophil extracellular trap(NETs)markers in patients with hepatitis B liver cirrhosis(LC)complicated by portal vein thrombosis(PVT).Methods 55 patients with LC caused by hepatitis B viral infection were admitted to our hospital between September 2018 and October 2022,the clinical materials was retrieved from the HIS system and the PVT was diagnosed by ultrasonography(US).Serum myeloperoxidase(MPO),neutrophil elastase(NE)and citrullinated histone H3(CitH3)levels were assayed by ELISA.Results The US check-up revealed PVT in 21 cases(38.2%)in our series;the model for end-stage liver disease score,the percentages of Child class C and splenectomy history in patients with PVT were 18.2(17.6,19.5),52.4%and 42.9%,all significantly greater than[13.2(9.3,16.8),14.7%and 2.9%,P<0.05]in patients without PVT;serum bilirubin,D-dimer,neutrophil/lymphocyte ratio,MPO,NE and CitH3 levels in patients with PVT were 25.6(21.6,36.0)μmol/L,1095.0(532.5,2202.5)ng/ml,2.3(1.9,4.2),42.4(20.7,78.9)ng/ml,2468.2(1344.8,5620.6)ng/ml and 79.2(44.8,126.2)ng/ml,all significantly greater than[18.9(16.5,28.3)μmol/L,390.0(280.0,680.0)ng/ml,1.9(1.2,2.6),10.8(5.6,16.0)ng/ml,623.5(241.4,1006.3)n g/ml and 28.8(10.4,39.6)ng/ml,respectively,P<0.05],while serum albumin level was(31.5±5.8)g/L,much lower than[(35.4±5.8)g/L,P<0.05]in patients without PVT.Conclusion The splenectomy might increase the incidence of PVT in patients with hepatitis B infection-induced LC,and conceal the blood routine manifestations of hypersplenism,while the increased serum NETs markers could remind the necessary of in time clinical management.
作者
吴大海
刘其林
卢杰夫
梁玉梅
Wu Dahai;Liu Qilin;Lu Jiefu(Department of Gastroenterology,Fifth Affiliated Hospital,Guangxi Medical University,Nanning 530022,Guangxi Zhuang Autonomous Region,China)
出处
《实用肝脏病杂志》
CAS
2024年第3期394-397,共4页
Journal of Practical Hepatology
基金
广西壮族自治区南宁市科学与技术开发研究计划项目(编号:ZC20193006)。
关键词
肝硬化
脾切除
门静脉血栓形成
中性粒细胞胞外陷阱
Liver cirrhosis
Splenectomy
Portal vein thrombosis
Neutrophil extracellular traps markers
