交通医学

目的：分析不同临床分期慢性乙型肝炎病毒（hepatitis B virus,HBV）感染患者血清嗜酸性粒细胞趋化因子11(eosinophilic chemotactic protein 11,CCL11)水平及其临床意义。方法：慢性HBV感染初治患者110例，分为HBeAg阳性慢性HBV感染组20例、HBeAg阳性慢性乙型肝炎（chronic hepatitis B,CHB）组23例、HBeAg阴性慢性HBV感染组27例、HBeAg阴性CHB组24例、乙型肝炎肝硬化组16例。采用酶联免疫吸附法检测各组患者血清CCL11水平，应用Pearson相关系数分析血清CCL11水平与慢性HBV感染患者HBV DNA载量及肝功能指标的相关性。结果：HBe Ag阳性慢性HBV感染组血清CCL11水平低于HBeAg阳性CHB组、HBeAg阴性CHB组及乙肝肝硬化组（均P<0.05）;HBeAg阳性CHB组血清CCL11水平低于HBeAg阴性CHB组和乙肝肝硬化组（均P<0.05）;HBeAg阴性慢性HBV感染组血清CCL11水平低于HBeAg阴性CHB组及乙肝肝硬化组（均P<0.05）。Pearson相关分析显示，慢性HBV感染患者血清CCL11水平与丙氨酸转氨酶（alanine aminotransferase,ALT）(r=0.205,P=0.042)、天冬氨酸转氨酶（aspartate aminotransferase,AST）呈正相关（r=0.294,P=0.003），与HBV DNA载量无相关性（r=0.141,P=0.170）。结论：随着慢性HBV感染患者临床分期的进展，血清CCL11水平呈现逐渐升高的趋势，血清CCL11水平与肝转氨酶存在相关性，提示CCL11在肝脏炎症及纤维化过程中可能发挥重要作用。

Objective: To analyze the serum level of eosinophilic chemotactic protein 11(CCL11) in patients with chronic hepatitis B virus(HBV) infection at different clinical stages and its clinical significance. Methods: A total of 110 patients with chronic HBV infection who were newly diagnosed were included. The patients were divided into 5 groups: 20 cases of HBeAg-positive chronic HBV infection, 23 cases of HBeAg-positive chronic hepatitis B(CHB), 27 cases of HBeAg-negative chronic HBV infection, 24 cases of HBeAg-negative CHB, and 16 cases of hepatitis B liver cirrhosis.Enzyme-linked immunosorbent assay(ELISA) was used to detect the serum levels of CCL11 of patients in each group.Pearson correlation coefficient analysis was conducted to investigate the correlation between serum CCL11 levels and HBV DNA load as well as liver function indicators in patients with chronic HBV infection. Results: The serum CCL11 level in the HBeAg-positive chronic HBV infection group was lower than that in the HBeAg-positive CHB group, the HBeAgnegative CHB group, and the hepatitis B liver cirrhosis group(all P<0.05). The serum CCL11 level in the HBeAg-positive CHB group was lower than that in the HBeAg-negative CHB group and the hepatitis B liver cirrhosis group(all P<0.05).The serum CCL11 level in the HBeAg-negative chronic HBV infection group was lower than that in the HBeAg-negative CHB group and the hepatitis B liver cirrhosis group(P <0.05). The Pearson correlation analysis showed that the serum CCL11 level in patients with chronic HBV infection was positively correlated with alanine aminotransferase(ALT)(r=0.205,P=0.042) and aspartate aminotransferase(AST)(r=0.294, P=0.003), but not correlated with HBV DNA load(r=0.141, P=0.170). Conclusion: As the clinical stage of patients with chronic HBV infection progresses, the serum CCL11 level shows a gradually increasing trend. The serum CCL11 level is correlated with liver transaminase, suggesting that CCL11 may play an important role in the process of liver inflammation and fibrosis.