The Detection And Significance Of Serum ICAM-1 And D-D In The Patients With Chronic Severe Hepatitis B And The Studies Of The Influence On Both With Entecavir

Objective Selecting patients with chronic severe hepatitis B(CSHB) as the study object, through observing the level change of serum intercellular adhesion molecule- 1(ICAM- 1) and D-dimer (D-D) before and after treatment, discussing the relationship,mechanism of effect and the significance with ICAM- 1,D-D.At the same time , observed entecavir through the influence of ICAM-1 ,D-D, hepatitis B vivas- deoxyribonudeic acid(HBV-DNA), TBIL, alanine aminotransferase (ALT), aspartate aminotransferase(AST), albumin(ALB) and prothrombin activity (PTA),to discuss the treatment effect, mechanisms of liver injury and the curative effect to the patients with CSHB. Methods Selecting 66 patients with CSHB at the Infections diseases department of the Affiliated Hospital of Ningxia Medical university in September 2007- March 2010 , include 31 patients afforded antiviral treatment with entecavir. Collected all patients'serum before treatment and after 6 weeks of treatment for use later. Detecte the level of ICAM- 1 and D-D in all the serum by using enzyme-linked immunsorben tassay(ELISA); detected serum HBV-DNA carrying adopting real time fluorescent quqntity polymerase chain reaction(RT-PCR); detected TBIL,ATL,AST and ALB by automatic biochemical analyzer; detected PTA by automated coagulation analyzer,and used spss 11.5 for the data analysis. Result 1.After treatment, the level of serum ICAM-1 and D-D are obviously decline than before, there was significant differences in statistical (P <0.01).2.Compared with controls, level of serum ICAM-1, D-D dropped more obvious in treatment group , there was Obvious differences in statistical (P<0.05). 3.There is positive correlation between level of ICAM-1 and TBIL in all patients'serum (r=0.899, P=0.00); positive correlation between ICAM-1 and ALT(r=0.964 , P=0.00).4.There is positive correlation between level of D-D and TBIL in all patients'serum (r=0.928, P=0.00); positive correlation between D-D and ALT(r=0.857, P=0.00); and negative correlated between D-D and PTA (r=- 0.783, P=0.00).5.After treatment, the levwl of serum TBIL, ALT , PTA recovered obviously; Compared with the control group, the treatment has a better curative effect,there was obvious differences in statistical (P<0.05).6.In the reduction of HBV-DNA load, the treatment group has a better curative effect than the control,there was significant differences in statistical (P=0.009<0.01).7.Aboat the mortality rate, the treatment has a lower rate than the control's, there was obvious differences in statistical (P=0.036 < 0.05); and aboat the total effective rate, the treatment group obviously higher than the control group, there was obvious differences in statistical (P=0.036 < 0.05). Conclusion 1.After treatment ,the level of ICAM-1 and D-D in CSHB patients'serum lower than before obviously, prompt that ICAM-1 and D-D participated in the liver injury process of CSHB. 2.Entecavir can reduce serum ICAM-1 and D-D level, prevent the further development of the liver inflammation.3.Entecavir can reduce the HBV-DNA load in CSHB serum quickly, play a crucial important part in protect the remaining liver cells,the regenerative liver cells, and in prohibit the progress of disease .