BMC Gastroenterology: 血浆超氧化物歧化酶水平在HBV相关慢加急性肝衰竭中的预后价值分析

2022-07-12 xuyihan MedSci原创

慢加急性肝衰竭(ACLF)是指各种急性损伤因素作用下,肝功能相对稳定的慢性肝病患者迅速恶化的肝衰竭综合征。按从发病到出现肝衰竭综合征的时间(以2周为界),ACLF可分为慢加急性和慢加亚急性肝衰竭。

慢性急性加重肝功能衰竭(ACLF)是一种严重的临床综合征,伴有肝功能恶化,短期死亡率高。而乙型肝炎病毒 (HBV) 感染是世界上(尤其是亚洲)最具挑战性的健康问题之一,目前全世界有超过 3.5 亿人受到感染。慢性 HBV (CHB) 感染会导致一系列疾病,例如肝硬化、肝细胞癌 (HCC) 和肝功能衰竭。在中国,HBV 相关 ACLF(HBV-ACLF)占 ACLF 病例的 80% 以上,几乎 7.18% 的成人 HBV 表面抗原呈阳性。核苷类似物 (NAs) 用于治疗 CHB 感染并通过抑制 HBV 聚合酶活性有效抑制 HBV 复制。然而,所有这些药物(包括 ETV、LVD 和 LDT)仅抑制 HBV 逆转录,而不是消除病毒。

最近的一项研究表明,过度炎症在许多人类疾病的发病机制中起着重要作用,包括肝功能衰竭。炎症被认为具有保护作用并有助于抗菌反应,而过度炎症可能导致细胞损伤和细胞死亡。活性氧 (ROS) 已被证明对 ACLF 发病过程中的 NLRP3 启动和炎症激活至关重要。超氧化物歧化酶 (SOD) 将有毒的超氧化物转化为过氧化氢,是一种重要的内源性抗氧化酶,可对抗细胞内氧化应激。因此,本项研究旨在探究SOD的血浆水平是否与 HBV-ACLF 患者的疾病严重程度和预后相关。

研究人员收集并分析了来自200名 HBV-ACLF 患者以及年龄和性别匹配的肝硬化和健康对照者的血浆样本和临床数据。使用 ELISA 商业试剂盒测量 SOD 的血浆水平。然后对SOD的血浆水平与患者的肝功能情况进行了相关性分析。

研究结果显示在HBV-ACLF患者中,恩替卡韦(ETV)停药组的病死率高于ETV持续治疗组(69.95% vs 46.71%,P<0.05)。此外,ETV戒断组的 HBV-DNA 和 SOD 血浆水平高于 ETV治疗组(Log 10(HBV-DNA):6.49 ± 0.24 vs 4.79 ± 0.14,P  < 0.01;SOD:463.1 ± 27.61 U/mL VS  397.2 ± 10.97 U/mL,P< 0.05)。血浆 SOD > 428 U/mL 的 HBV-ACLF 患者的死亡率和肝移植率明显高于血浆 SOD 水平≤ 428 U/mL 的患者。

本项研究证实停止ETV治疗引起的HBV再激活和氧化应激升高是HBV-ACLF发病机制的关键因素。血浆 SOD 水平可作为评估疾病严重程度和预测停止 ETV 治疗的 HBV-ACLF 患者预后的有用生物标志物。

 

原始出处:

Naijuan Yao. Et al. Prognostic value of plasma level of superoxide dismutase in HBV-related acute-on-chronic liver failure. BMC Gastroenterology.2022.

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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ffe15705834, createdName=ms4000001809038213, createdTime=Wed Jul 13 03:18:16 CST 2022, time=2022-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290495, encodeId=2b4112904955f, content=<a href='/topic/show?id=fb34523817d' target=_blank style='color:#2F92EE;'>#急性肝衰竭#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52381, encryptionId=fb34523817d, topicName=急性肝衰竭)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f54230, createdName=xlysu, createdTime=Wed Jul 13 02:12:22 CST 2022, time=2022-07-13, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1635844, encodeId=6f5116358449b, content=<a href='/topic/show?id=9e5781499dd' target=_blank style='color:#2F92EE;'>#肝衰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81499, encryptionId=9e5781499dd, topicName=肝衰)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fedc22527786, createdName=1249884fm94暂无昵称, createdTime=Wed Dec 28 16:12:22 CST 2022, time=2022-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1975210, encodeId=b5df19e521001, content=<a href='/topic/show?id=f145355379' target=_blank style='color:#2F92EE;'>#BMC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3553, encryptionId=f145355379, topicName=BMC)], attachment=null, authenticateStatus=null, 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href='/topic/show?id=f9d08524be' target=_blank style='color:#2F92EE;'>#HBV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8524, encryptionId=f9d08524be, topicName=HBV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e87531, createdName=klivis, createdTime=Thu Sep 15 23:12:22 CST 2022, time=2022-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2065549, encodeId=5e83206554966, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Sun Jul 17 12:12:22 CST 2022, time=2022-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1232157, encodeId=9c68123215e36, content=<a href='/topic/show?id=62a910455418' target=_blank style='color:#2F92EE;'>#超氧化物歧化酶#</a>与<a href='/topic/show?id=fe1b81500a3' target=_blank style='color:#2F92EE;'>#肝衰竭#</a>这样的老话题还能发文章,牛!, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104554, encryptionId=62a910455418, topicName=超氧化物歧化酶), TopicDto(id=81500, encryptionId=fe1b81500a3, topicName=肝衰竭)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/Random/55971dc507c93968175ce7cc1e177b372a83869f.jpg, createdBy=f63e4754896, createdName=小小医者, createdTime=Wed Jul 13 03:35:30 CST 2022, time=2022-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1232151, encodeId=43d1123215128, content=学习了,感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ffe15705834, createdName=ms4000001809038213, createdTime=Wed Jul 13 03:18:16 CST 2022, time=2022-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290495, encodeId=2b4112904955f, content=<a href='/topic/show?id=fb34523817d' target=_blank style='color:#2F92EE;'>#急性肝衰竭#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52381, encryptionId=fb34523817d, topicName=急性肝衰竭)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f54230, createdName=xlysu, createdTime=Wed Jul 13 02:12:22 CST 2022, time=2022-07-13, status=1, ipAttribution=)]
    2022-09-29 许安
  5. [GetPortalCommentsPageByObjectIdResponse(id=1635844, encodeId=6f5116358449b, content=<a href='/topic/show?id=9e5781499dd' target=_blank style='color:#2F92EE;'>#肝衰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81499, encryptionId=9e5781499dd, topicName=肝衰)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fedc22527786, createdName=1249884fm94暂无昵称, createdTime=Wed Dec 28 16:12:22 CST 2022, time=2022-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1975210, encodeId=b5df19e521001, content=<a href='/topic/show?id=f145355379' target=_blank style='color:#2F92EE;'>#BMC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3553, encryptionId=f145355379, topicName=BMC)], attachment=null, authenticateStatus=null, 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  6. 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href='/topic/show?id=f9d08524be' target=_blank style='color:#2F92EE;'>#HBV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8524, encryptionId=f9d08524be, topicName=HBV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e87531, createdName=klivis, createdTime=Thu Sep 15 23:12:22 CST 2022, time=2022-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2065549, encodeId=5e83206554966, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Sun Jul 17 12:12:22 CST 2022, time=2022-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1232157, encodeId=9c68123215e36, content=<a href='/topic/show?id=62a910455418' target=_blank style='color:#2F92EE;'>#超氧化物歧化酶#</a>与<a href='/topic/show?id=fe1b81500a3' target=_blank style='color:#2F92EE;'>#肝衰竭#</a>这样的老话题还能发文章,牛!, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104554, encryptionId=62a910455418, topicName=超氧化物歧化酶), TopicDto(id=81500, encryptionId=fe1b81500a3, topicName=肝衰竭)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/Random/55971dc507c93968175ce7cc1e177b372a83869f.jpg, createdBy=f63e4754896, createdName=小小医者, createdTime=Wed Jul 13 03:35:30 CST 2022, time=2022-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1232151, encodeId=43d1123215128, content=学习了,感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ffe15705834, createdName=ms4000001809038213, createdTime=Wed Jul 13 03:18:16 CST 2022, time=2022-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290495, encodeId=2b4112904955f, content=<a href='/topic/show?id=fb34523817d' target=_blank style='color:#2F92EE;'>#急性肝衰竭#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52381, encryptionId=fb34523817d, topicName=急性肝衰竭)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f54230, createdName=xlysu, createdTime=Wed Jul 13 02:12:22 CST 2022, time=2022-07-13, status=1, ipAttribution=)]
    2022-09-15 klivis
  7. 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  8. 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    2022-07-13 小小医者

    #超氧化物歧化酶##肝衰竭#这样的老话题还能发文章,牛!

    0

  9. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ffe15705834, createdName=ms4000001809038213, createdTime=Wed Jul 13 03:18:16 CST 2022, time=2022-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290495, encodeId=2b4112904955f, content=<a href='/topic/show?id=fb34523817d' target=_blank style='color:#2F92EE;'>#急性肝衰竭#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52381, encryptionId=fb34523817d, topicName=急性肝衰竭)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f54230, createdName=xlysu, createdTime=Wed Jul 13 02:12:22 CST 2022, time=2022-07-13, status=1, ipAttribution=)]
    2022-07-13 ms4000001809038213

    学习了,感谢

    0

  10. 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