摘要目的 探讨不同疾病程度乙肝肝硬化患者免疫球蛋白(immunoglobulin,Ig)、血清人可溶性P选择素(soluble P-selectin,sP-selectin)、血清可溶性细胞间黏附分子-1(serum soluble intercellular ad-hesion molecule-1,sICAM-1)水平的变化及其可能的临床意义.方法 纳入西藏自治区人民政府驻成都办事处医院消化科2013年5月至2017年5月收治的80例肝硬化患者,根据肝硬化程度分为代偿组、失代偿组、原发性肝癌组,采集患者血液标本,进行Ig、血清sP-selectin、sICAM-1、肝功能指标[谷丙转氨酶(alanine aminotransferase,ALT)和谷草转氨酶(aspartate aminotransferase,AST)碱性磷酸酶(alkaline phos-phatase,ALP)]检测,比较三组患者上述指标检测结果.根据肝硬化Child-Pugh分级将研究对象分为A组、B组、C组,对上述指标表达变化与肝功能指标的相关性进行分析.结果 原发性肝癌组IgM、IgG、IgA、血清sP-selectin、sICAM-1水平均高于代偿组和失代偿组(P＜0.05),失代偿组上述指标检测结果均高于代偿组(P＜0.05).C组上述指标水平均高于A组和B组(P＜0.05),B组上述指标检测结果均高于A组(P＜0.05).Pearson相关性分析结果显示,患者IgM、IgG、IgA、血清sP-selectin、sICAM-1水平与肝功能指标ALT、AST、ALP水平均呈正相关(P＜0.05).结论 Ig、血清sP-selectin、sICAM-1表达水平与肝硬化程度相关,可作为肝硬化患者治疗效果和预后评估的依据.

abstractsObjective To investigate the changes of immunoglobulin(Ig),serum human soluble P-se-lectin(sP-selectin)and serum soluble intercellular adhesion molecule-1(sICAM-1)in patients with hepatitis B cirrhosis and the possible clinical significance. Methods All of the 80 patients with hepatitis B cirrhosis admit-ted to Hospital of Chengdu office of People's Government of Tibetan Autonomous Region from May 2013 to May 2017 were enrolled. According to the Child-Pugh classification of cirrhosis,the subjects were divided into group A,group B and group C. Blood samples were collected for Ig,sP-selectin,sICAM-1 detection,and the index of liver function[ alanine aminotransferase( ALT),( aspartate aminotransferase,AST),alkaline phosphatase , ALP)]were tested at the same time. According to the degree of cirrhosis,the subjects were divided into com-pensation group,decompensation group and primary liver cancer group. The results of the indicators were com-pared among the three groups of patients. The results of the above indicators were compared between the three groups of patients,and the correlation between the the indicators and the liver function were analyzed. Results The levels of IgM,IgG,IgA,sP-selectin and sICAM-1 in the primary liver cancer group were higher than those in the compensatory group and the decompensated group(both P ＜ 0. 05). The indicators in group C were higher than those in group A and group B(P ＜ 0. 05). The results of indexes in group B were higher than those in group A(P ＜ 0. 05). Pearson correlation analysis showed that the levels of IgM,IgG,IgA,sP-selectin and sI-CAM-1 were positively correlated with liver function indexes ALT,AST and ALP(P ＜ 0. 05). Conclusion The levels of Ig,sP-selectin and sICAM-1 can be used as an auxiliary index for the treatment response and prognosis evaluation of patients with hepatitis B cirrhosis.