Zhang Jian, Ma Junwei, Wang Hongxin, Li Junhong
Department of Emergency, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, P.R. China.
Exp Ther Med. 2018 Mar;15(3):2951-2955. doi: 10.3892/etm.2018.5738. Epub 2018 Jan 11.
The study assessed the correlation between cortisol (COR) levels and concurrent infection for the patients with hepatitis B cirrhosis for corresponding countermeasure analysis. In total, 86 patients with hepatitis B cirrhosis (non-infection group) and 32 patients with hepatitis B cirrhosis complicated with infection (infection group) who were diagnosed and treated in the Beijing YouAn Hospital from March 2014 to March 2017 were selected. The fasting venous blood of all the patients was drawn to detect COR, cortisol binding globulin (CBG), blood routine indexes, C-reactive protein (CRP), procalcitonin (PCT), endotoxin and other indicators. The relative expression of CBG mRNA was detected by reverse transcription quantitative polymerase chain reaction (RT-qPCR). The differences and correlation of COR levels between the infection and non-infection groups were compared and analyzed. The concentrations of COR and CBG were decreased with the increase of Child-Pugh grade, and the difference was statistically significant (P<0.05). COR, CBG and free cortisol (FC) concentrations with the same Child-Pugh grade in the non-infection group were higher than those in the infection group (P<0.05). COR, CBG and FC concentrations of abdominal infection complicated with sepsis or abdominal infection complicated with pulmonary infection were lower than those of simple abdominal infection (P<0.05). The relative expression of CBG mRNA was detected by RT-qPCR, which also showed that: for Child-Pugh grade, grade A > grade B > grade C (P<0.05), non-infection group > infection group (P<0.05), abdominal infection + sepsis group and abdominal infection + pulmonary infection group were lower than the simple abdominal infection group (P<0.05). The values of white blood cells (WBC), neutrophils, CRP, PCT and endotoxin in the infection group were higher than those in the non-infection group, and the differences were statistically significant (P<0.05). COR, CGB and FC were negatively correlated with inflammatory indexes such as WBC, neutrophils, CRP, PCT and endotoxin. The r value of COR and FC in the non-infection group was 0.678, while that of OR and FC in the infection group was 0.787. COR was positively correlated with FC before and after infection. The results of the study show that the cortisol levels of patients with hepatitis B cirrhosis are significantly correlated with whether infected or not, levels of disease condition and infection types, and can be used as sensitive indicators of hepatitis B cirrhosis infection.
本研究评估了乙型肝炎肝硬化患者皮质醇（COR）水平与并发感染之间的相关性，以进行相应的对策分析。选取2014年3月至2017年3月在北京佑安医院确诊并治疗的86例乙型肝炎肝硬化患者（非感染组）和32例乙型肝炎肝硬化合并感染患者（感染组）。采集所有患者的空腹静脉血，检测COR、皮质醇结合球蛋白（CBG）、血常规指标、C反应蛋白（CRP）、降钙素原（PCT）、内毒素等指标。采用逆转录定量聚合酶链反应（RT-qPCR）检测CBG mRNA的相对表达。比较分析感染组与非感染组COR水平的差异及相关性。COR和CBG浓度随Child-Pugh分级升高而降低，差异有统计学意义（P<0.05）。非感染组中相同Child-Pugh分级的COR、CBG和游离皮质醇（FC）浓度高于感染组（P<0.05）。腹部感染合并脓毒症或腹部感染合并肺部感染的COR、CBG和FC浓度低于单纯腹部感染（P<0.05）。通过RT-qPCR检测CBG mRNA的相对表达，结果还显示：对于Child-Pugh分级，A级> B级> C级（P<0.05），非感染组>感染组（P<0.05），腹部感染+脓毒症组和腹部感染+肺部感染组低于单纯腹部感染组（P<0.05）。感染组白细胞（WBC）、中性粒细胞、CRP、PCT和内毒素值高于非感染组，差异有统计学意义（P<0.05）。COR、CGB和FC与WBC、中性粒细胞、CRP、PCT和内毒素等炎症指标呈负相关。非感染组COR与FC的r值为0.678，而感染组OR与FC的r值为0.787。感染前后COR与FC呈正相关。研究结果表明，乙型肝炎肝硬化患者的皮质醇水平与是否感染、病情严重程度及感染类型显著相关，可作为乙型肝炎肝硬化感染的敏感指标。
