慢性乙型肝炎血清标志物和肝功能指标在不同性别患者间的差异分析

肝脏 ›› 2021, Vol. 26 ›› Issue (2): 128-130.

慢性乙型肝炎血清标志物和肝功能指标在不同性别患者间的差异分析

方钟, 王丛, 黄玉仙, 陈良, 张毅

201508 复旦大学附属公共卫生临床中心(方钟,王丛,黄玉仙,陈良,张毅);复旦大学附属中山医院肝癌研究所,癌变与侵袭原理教育部重点实验室(方钟)

收稿日期:2020-11-14 出版日期:2021-02-28 发布日期:2021-03-28
通讯作者: 张毅,Email:zhangyi117 @shphc.org.cn
基金资助:
上海市公共卫生临床中心科研启动基金(KY-GW-2019-22)

Analysis of gender disparity of viral markers and liver function indicators in chronic hepatitis B patients

FANG Zhong^1,2, WANG Cong¹, HUANG Yu-xian¹, CHEN Liang¹, ZHANG Yi¹

1. Shanghai Public Health Clinical Center, Affiliated to Fudan University, Shanghai 201508, China;
2. Liver Cancer Institute, Zhongshan Hospital, and Key Laboratory of Carcinogenesis and Cancer Invasion (Ministry of Education), Fudan University, Shanghai 200032, China

Received:2020-11-14 Online:2021-02-28 Published:2021-03-28
Contact: ZHANG Yi, Email: zhangyi117@shphc.org.cn

摘要/Abstract

摘要： 目的探索不同性别慢性乙型肝炎患者病毒学和血清学指标的差异。方法回顾性研究了155例慢性乙型肝炎初治患者的血清学指标。并在HBeAg是否发生血清学转换的情况下分别比较了不同性别患者:HBeAg或抗-HBe、HBsAg、抗-HBc和HBV DNA:ALT、AST和GGT:TBil、Alb、Glb、PT、INR和PLT的相关性。结果在HBeAg阴性患者中,男性血清中的HBsAg和HBV DNA显著高于女性患者(分别为1 696 IU/mL比137.9 IU/mL,P=0.029 4;1.84×10⁷拷贝/mL比6.69×10⁷拷贝/mL,P=0.003 9)。HBsAg在男性患者中始终与HBV DNA存在显著正相关(P<0.01),女性患者的这一相关性在HBeAg发生血清学转换后消失(P=0.550 6);在HBeAg未发生转换时,男性患者的HBsAg水平与TBil和PT水平负相关(P=0.0158及P=0.0317)。结论在慢性乙型肝炎疾病进展的不同时期,不同性别患者不仅HBV DNA和HBsAg水平存在不同,其他血清学指标中也存在显著区别。

关键词: 慢性乙型肝炎, 性别, 肝功能, 乙肝表面抗原

Abstract: Objective To clarify the sex disparity of chronic hepatitis B in seum viral markers and liver function parameters.Methods Clinical informations from 155 chronic hepatitis B (CHB) patients were analyzed in this retrospective study. HBeAg or HBeAb, HBsAb, HBcAb and HBV DNA in different genders were compared between the cases with and those without HBeAg seroconversion. The relationship between HBsAg levels and liver injury Indicators including alanine aminotransferase (ALT), aspartate aminotransferase (AST) and glutamyl transpeptidase (GGT), and other serological markers such as total bilirubin (TB), albumin (ALB), globin (GLB), prothrombin time (PT), international normalized ratio (INR) and platelet count (PLT). Results In HBeAg-negative patients, the serum levels of HBsAg and HBV DNA in males were significantly higher than in females. When analysis the correlation of these clinical indicators with HBsAg, it was found that HBsAg positively correlated with HBV DNA in males and in HBeAg positive females. In addition, there are a negative correlation between HBsAg and TB, PT or AST in HBeAg positive males.Conclusion Gender disparity is not only presented in viral markers, but also in other serological indicators in CHB patients.

Key words: Chronic hepatitis B, Gender disparity, Liver function, HBsAg

方钟, 王丛, 黄玉仙, 陈良, 张毅. 慢性乙型肝炎血清标志物和肝功能指标在不同性别患者间的差异分析[J]. 肝脏, 2021, 26(2): 128-130.

FANG Zhong, WANG Cong, HUANG Yu-xian, CHEN Liang, ZHANG Yi. Analysis of gender disparity of viral markers and liver function indicators in chronic hepatitis B patients[J]. Chinese Hepatolgy, 2021, 26(2): 128-130.

参考文献

[1] Meng Z, Ma Z, Zhang E, et al. Novel woodchuck hepatitis virus (WHV) transgene mouse models show sex-dependent WHV replicative activity and development of spontaneous immune responses to WHV proteins. J Virol, 2014, 88:1573-1581.
[2] Wang SH, Yeh SH, Lin WH, et al. Identification of androgen response elements in the enhancer I of hepatitis B virus: a mechanism for sex disparity in chronic hepatitis B. Hepatology, 2009, 50:1392-1402.
[3] Wang Q, Michailidis E, Yu Y, et al. A combination of human broadly neutralizing antibodies against hepatitis B virus HBsAg with distinct epitopes suppresses escape mutations. Cell Host Microbe, 2020, 28: 335-349 e6.
[4] Fang Z, Yu X, Tong S, et al. Serum ERK1/2 proteins fluctuating with HBV infection report frequency of viral-specific CD8(+) T cells and predict IFNalpha therapeutic effect in chronic hepatitis B patients. Clin Immunol, 2020, 219(108570).
[5] Guidotti LG, Ishikawa T, Hobbs MV, et al. Intracellular inactivation of the hepatitis B virus by cytotoxic T lymphocytes. Immunity, 1996, 4: 25-36.
[6] Kosinska AD, Johrden L, Zhang E, et al. DNA prime-adenovirus boost immunization induces a vigorous and multifunctional T-cell response against hepadnaviral proteins in the mouse and woodchuck model. J Virol, 2012, 86: 9297-9310.
[7] Kosinska AD, Pishraft-Sabet L, Wu W, et al. Low hepatitis B virus-specific T-cell response in males correlates with high regulatory T-cell numbers in murine models. Hepatology, 2017, 66: 69-83.
[8] Ayano G, Tulu M, Haile K, et al. A systematic review and meta-analysis of gender difference in epidemiology of HIV, hepatitis B, and hepatitis C infections in people with severe mental illness. Ann Gen Psychiatry, 2018, 17(16).
[9] Tong S. Hepatitis B virus, a sex hormone-responsive virus. Gastroenterology, 2012, 142: 696-699.
[10] Nfor ON, Wu MF, Debnath T, et al. Hepatitis B virus infection in Taiwan: the role of NTCP rs2296651 variant in relation to sex. J Viral Hepat, 2018, 25: 1116-1120.

[1]	林川, 王秋, 游昕. 射频消融与微波消融联合放疗对伴门静脉癌栓原发性肝癌患者的治疗效果比较[J]. 肝脏, 2021, 26(2): 167-170.
[2]	梅宝富, 邓志锋, 郑兰, 林堆贤. γ-谷氨酰转肽酶和血小板比值对肝癌介入术后急性肝功能恶化的预测作用[J]. 肝脏, 2021, 26(2): 175-178.
[3]	许俊, 谢国艳, 黄敏. 慢性乙型肝炎患者血清可溶性E-钙黏蛋白表达与氧化应激的相关性分析[J]. 肝脏, 2021, 26(1): 19-21.
[4]	林彬彬, 肖志鸿, 王菲, 阮清发, 汤钰菁, 欧阳丽娟. 慢性乙型肝炎恩替卡韦经治后联合长效干扰素的疗效预测分析[J]. 肝脏, 2021, 26(1): 27-32.
[5]	冯少阳, 李广明, 苏航. 瞬时弹性成像对慢性乙型肝炎合并非酒精性脂肪性肝病患者肝纤维化的评估价值[J]. 肝脏, 2021, 26(1): 44-46.
[6]	赵海东, 陈灵峰, 林巧欣, 李艺芳. 聚乙二醇干扰素α短期治疗HBsAg水平极低的非活动性HBsAg携带者的疗效观察[J]. 肝脏, 2020, 25(9): 937-939.
[7]	高文, 杨雪, 窦爱华, 惠威, 刘梅, 徐斌, 段钟平. 维生素D缺乏对乙型肝炎患者的影响[J]. 肝脏, 2020, 25(9): 940-942.
[8]	邓琰, 吴凡, 陈芦斌, 李宁宇, 寇伟伟, 王云. ERCP联合吡喹酮治疗肝吸虫病并发胆道梗阻患者临床疗效研究[J]. 肝脏, 2020, 25(9): 968-971.
[9]	任建峰, 张玉萍, 邵静, 张其胜, 高得勇, 王晓今. 新型冠状病毒肺炎患者血氧饱和度与肝功能异常的相关性[J]. 肝脏, 2020, 25(9): 986-989.
[10]	景仕银, 仲崇俊. 肝癌顽固性疼痛行左侧单孔胸腔镜[J]. 肝脏, 2020, 25(7): 769-771.
[11]	朱萍, 赵杰, 程雪莲, 李德亮, 张伟业. Citrin缺陷合并肝内胆汁淤积症患儿的临床特征[J]. 肝脏, 2020, 25(6): 585-587.
[12]	姚煜, 戴峰, 徐春阳. 肝血管瘤血供类型对经肝动脉介入治疗效果的影响[J]. 肝脏, 2020, 25(6): 591-594.
[13]	周莹, 杨俊梅, 张桂珍, 甄明慧. 学龄前HBeAg阴性慢性乙型肝炎患儿临床特点分析[J]. 肝脏, 2020, 25(6): 605-606.
[14]	吴智慧, 丁媛. 慢性乙型肝炎肝硬化患者恩替卡韦抗病毒干预后肝脏弹性成像定量变化观察[J]. 肝脏, 2020, 25(6): 630-632.
[15]	贺尼娅, 王琳. 慢性乙型肝炎患者血清胆固醇与肝纤维化的相关性研究[J]. 肝脏, 2020, 25(6): 645-647.