| Background and Objective:Liver cirrhosis is the inevitable pathological process and terminal stage of chronic liver disease caused by various causes.In China,even all of the world,tens of thousands people died every year due to cirrhosis and its complications.The mechanism of the occurrence and progression of cirrhosis is very complicated,and inflammation and oxidative stress play an important role in its development.Heme oxygenase-1(HO-1)is an inducible enzyme widely present in the body.In recent years,it has been found that the induced expression of HO-1 and its catalytic products of heme can exert cytoprotective effects on tissues and organs through anti-inflammatory,anti-oxidation,anti-proliferation and apoptosis regulation,which can delay the maintenance of hepatitis development.High mobility group box 1(HMGB1)is a late inflammatory factor and pro-inflammatory factor discovered in recent years.Its expression level can be used as an important indicator to monitor the degree of liver fibrosis after hepatitis.Serum HO-1 and HMGB1 are closely related to the occurrence and development of cirrhosis.The correlation between the expression of HO-1 and HMGB1 in the serum of patients with liver cirrhosis at different stages of progression,and the relationship between their interaction or growth and the cirrhosis severity has not been reported.Therefore,the purpose of this study is to observe the changes of serum levels of HO-1 and HMGB1 in patients with liver cirrhosis at different stages of development;to explore the correlation between the levels of both levels and the severity of liver cirrhosis,in order to obtain sensitivity Biological markers to the assessment of liver cirrhosis and provide a reference for early treatment,delay or prevention of disease progression in cirrhosis.Methods:40 patients with compensation for cirrhosis,40 patients with decompensation,and15 healthy controls were included.The sera of the above subjects were collected for the detection of related indicators: biochemical indicators were detected by automatic biochemical analyzer and Roche reagent: the content of HO-1 and HMGB1 in serum was detected by ELASA method,and the thiobarbital method was used.The content of MDA and SOD in serum was detected bythiobarbital method and xanthine oxidase method.Results:1.There was no significant difference in serum HO-1 and HMGB1 levels among patients with cirrhosis of different genders,ages and causes(P>0.05).2.The levels of HO-1 and HMGB1 in serum of patients with cirrhosis were significantly higher than those in healthy controls.The cirrhosis-compensated group was higher than the decompensated group(P<0.05),and there was a significant difference.3.The levels of HO-1 in serum of patients with cirrhosis were significantly lower than those of CP-A and CP-B(P<0.05).There was no difference between CP-A and CP-B(P> 0.05);HMGB1 content in serum,CP-C level was significantly lower than CP-A level(P<0.05).Although there was no significant difference between CP-A level and CP-B level,CP-B level and CP-C level(P>0.05),it generally showed a decrease with the increase of Child-Pugh classification level.trend.4.In the serum of patients with cirrhosis with ascites,the content of HO-1 was no different from that without ascites(P>0.05),the content of HMGB1 was lower than that without ascites(P<0.05);patients with hepatic encephalopathy,The content of HO-1 in serum was lower than that in patients without hepatic encephalopathy(P<0.05),while the content of HMGB1 was higher than that in patients without hepatic encephalopathy(P<0.05).The content of HO-1 in serum of patients with gastrointestinal hemorrhage Compared with those without gastrointestinal bleeding(P<0.05),there was no significant difference in HMGB1 content(P>0.05).5.In patients with cirrhosis of Child-Pugh grade A,serum HO-1 levels decreasedwith increasing ALT,AST,GGT,and were negatively correlated,r values were-0.534,-0.360,-0.315,P<0.05;HO-1 was positively correlated with WBC and ALB,and the r values were 0.404,0.376,P<0.05,which were statistically significant;there was no correlation with ALP,TBIL,BUN and PLT.The content of serum HMGB1 increased with the increase of ALT,AST,ALP and GGT,and the positive values were 0.591,0.434,0.315,0.451,P<0.05,and negatively correlated with WBC and ALB.It was-0.307,-0.563,P<0.05,which was statistically significant;it had no correlation with TBIL,BUN,Scr,and PLT.In patients with cirrhosis of Child-Pugh grade B,serum HO-1 levels decreased with increasing ALT,AST,and ALP,and were negatively correlated,with r values of-0.553,-0.830,and-0.764,respectively.P<0.05;HO-1 was positively correlated with WBC and PLT,r values were 0.432,0.747,P<0.05,respectively,and statistically significant;but no correlation with GGT,TBIL,BUN,ALB.The content of serum HMGB-1 increased with the increase of AST and Scr,which was positively correlated.The r values were 0.532,0.534,P<0.05,respectively.They were negatively correlated with ALB and PLT,and the r values were-0.482,-0.451.,P <0.05,statistically significant;no correlation with ALT,ALP,GGT,TBIL,BUN,WBC.In patients with cirrhosis of grade C with Child-Pugh classification,serum HO-1levels were negatively correlated with ALT,ALP,and Scr,with r values ??of-0.764,-0.697,-0.825,P<0.05;HO-1 There is no correlation between AST,GGT,TBIL,BUN,WBC,ALB,and PLT.The content of serum HMGB1 was positively correlated with ALP,TBIL,BUN and Scr,and the r values ??were 0.883,0.420,0.839,0.762,P<0.05.HMGB1 was not associated with ALT,AST,GGT,WBC,ALB and PLT.6.In patients with cirrhosis of different Child-Pugh grades,serum HO-1 was positively correlated with SOD at CP-A and CP-B levels,and the correlation coefficients r were 0.674,0.590,P<0.05,and negatively correlated with MDA.The correlation coefficient r is-0.445,-0.767,P < 0.001;there is no correlation between CP-C grade HO-1 and SOD and MDA.HMGB1 was positively correlated with MDA at CP-A and CP-B levels,and the correlation coefficient r was 0.340,0.486,P<0.05;there was nocorrelation with SOD,and it was negatively correlated with SOD in cirrhosis CP-C level.Correlation coefficient r =-0.476,P < 0.05;no correlation with MDA.7.In patients with different Child-Pugh grade cirrhosis,HO-1 was negatively correlated with HMGB1 in serum,the correlation coefficient was the largest in CP-B,CP-C was the second,CP-A was the smallest,and the correlation coefficient r was-0.739,-0.664,-0.504,P < 0.05.8.The area under the HO-1 ROC curve is 0.636,the standard error is 0.064,and the95% confidence interval is(0.511,0.762),Sig=0.039,which is diagnostic.The area under the HMGB1 ROC curve is 0.732,the standard error is 0.058,and the 95%confidence interval is(0.619,0.864),sig <0.01,which has diagnostic value.In the curve,the HO-1 threshold is 206.90 U/L,the sensitivity is 78%,and the specificity is 45%;the HMGB1 threshold is 5.76 U/L,the sensitivity is 75.5%,and the specificity is 43.5%.Conclusion:1.Serum HO-1 and HMGB1 play an important role in the progression of cirrhosis,and the changes in the content of both are important in assessing the severity of cirrhosis patients.2.The levels of HO-1 and HMGB1 in serum can reflect the inflammation and oxidative stress levels of liver tissue.3.Serum HO-1 and HMGB1 levels are closely related to cirrhosis-related complications,and can be used as indicators to determine the complications of cirrhosis. |
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