关键词: 慢性乙型肝炎肝硬化, 乙型肝炎病毒S基因突变, 甲胎蛋白, 正五聚蛋白3, 预后

Abstract: Objective To investigate S gene mutation of hepatitis B virus (HBV) and to detect the levels of serum alpha fetoprotein (AFP) and pentraxin 3 (PTX3) in patients with HBV-related cirrhosis. Methods A total of 76 patients with HBV-related cirrhosis admitted to our hospital from July 2017 to June 2019 were selected as the study objects (cirrhosis group). Meanwhile, 87 patients with chronic hepatitis B (CHB) were selected as the control group (hepatitis group). Patients in cirrhosis group were divided into S gene mutation group (22 cases) and S gene nonmutation group (54 cases) according to whether the mutation of S gene occurred. The S gene mutation of HBV was detected by semi-nested polymerase chain reaction (PCR). The levels of AFP and PTX3 were detected by enzyme-linked immunosorbent assay (ELISA). The levels of serum total bilirubin (TBil), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were detected by automatic biochemical analyzer. Pearson method was used to analyze the correlation between liver function indexes and serum levels of AFP, PTX of patients in S gene mutation group. In addition, multivariate logistic regression was used to analyze factors affecting the prognosis of patients with HBV-related cirrhosis. Results The level of TBil [(42.59 ± 6.81) mol/L] and proportion of patients (22/54) with S gene mutation in cirrhosis group were higher than those in hepatitis group [(25.46 ± 7.32), (9/78)], the levels of AST [(156.83 ± 24.57) U/L], ALT [(125.31 ± 30.25) U/L] in cirrhosis group were lower than those in hepatitis group [(238.46 ± 40.22) U/L, (193.74 ± 42.81) U/L] (t=15.395, 9.114, 15.362, 11.626, all P<0.05); The levels of serum AFP (5.98 ± 2.01) ng/mL and PTX3 (5.24 ± 1.43) μg/L in S gene mutation group were higher than those in S gene nonmutation group [(4.86 ± 1.34) ng/mL, (3.84 ± 1.05) μg/L] (t=2.839, 4.729, all P<0.05). The levels of serum AFP and PTX3 were positively correlated with TBil (r=0.502, 0.479, all P<0.05), negatively correlated with AST and ALT (P<0.05) in patients with HBV-related cirrhosis and S gene mutation. S gene mutation was related to the prognosis of patients with HBV-related cirrhosis (r=0.553, P<0.05) and the proportion of poor prognosis was higher than that of good prognosis (86.36% VS 13.64%). S gene mutation and AFP were independent risk factors for the poor prognosis of patients with HBV-related cirrhosis (P<0.05). Conclusion S gene mutation may induce the increased levels of serum AFP and PTX3 in patients with HBV-related cirrhosis, and may be a significant index in predicting the adverse prognosis.

Key words: Hepatitis B virus-related cirrhosis, S gene mutation of hepatitis B virus, Alpha fetoprotein, Pentraxin 3, Prognosis