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目的评价腹腔白细胞维生素D受体(vitamin D receptor,VDR)及LL-37是否参与了自发性细菌性腹膜炎(spontaneous bacterial peritonitis,SBP)的发病机制。方法应用Real-ti me PCR方法检测19例肝硬化合并SBP患者及28例单纯腹水患者的腹腔白细胞VDR及LL-37 mRNA表达水平。评价它们与SBP的相关性,并分析肝硬化合并SBP患者的VDR及LL-37 mRNA水平的相关性。结果肝硬化合并SBP患者腹腔白细胞VDRmRNA表达水平为6.79×10-3±7.60×10-4,肝硬化单纯腹水患者为4.13×10-3±4.43×10-4,肝硬化合并SBP患者腹腔白细胞VDR水平显著高于单纯腹水患者,差异有统计学意义(P<0.01)。肝硬化合并SBP患者腹腔白细胞LL-37 mRNA表达水平为6.81×10-5±1.47×10-5,单纯腹水患者为1.74×10-5±2.42×10-6,前者显著高于后者,差异有统计学意义(P<0.01)。肝硬化合并SBP患者腹腔白细胞LL-37 mRNA表达水平与VDRmRNA表达水平呈正相关(r=0.700,P<0.01);一元线性回归模型有统计学意义(β=0.01,P=0.001;R2=0.491,F=16.376,P=0.001)。结论相比于肝硬化单纯腹水患者,肝硬化合并SBP患者腹腔白细胞VDR及LL-37 mRNA表达同步上调,表明维生素D-VDR系统及下游基因LL-37参与了SBP的发病机制。
Objective To evaluate whether VDR and LL-37 are involved in the pathogenesis of spontaneous bacterial peritonitis (SBP). Methods The expression of VDR and LL-37 mRNA in peritoneal leukocytes of 19 cirrhotic patients with SBP and 28 ascites patients were detected by Real-ti me PCR. Their association with SBP was assessed and the correlation between VDR and LL-37 mRNA levels in cirrhotic patients with SBP was analyzed. Results The expression of VDR mRNA in peritoneal leukocytes was 6.79 × 10-3 ± 7.60 × 10-4 in cirrhotic patients with SBP and 4.13 × 10-3 ± 4.43 × 10-4 in cirrhotic patients with ascites, The level was significantly higher than ascites patients, the difference was statistically significant (P <0.01). The expression of LL-37 mRNA in peritoneal leucocytes in cirrhotic patients with SBP was 6.81 × 10-5 ± 1.47 × 10-5, while in ascites patients was 1.74 × 10-5 ± 2.42 × 10-6, the former was significantly higher than the latter There was statistical significance (P <0.01). The expression of LL-37 mRNA in peritoneal leucocytes in cirrhotic patients with SBP was positively correlated with the expression of VDR mRNA (r = 0.700, P <0.01); the linear regression model was statistically significant (β = 0.01, P = 0.001; F = 16.376, P = 0.001). Conclusions Compared with cirrhotic patients with ascites, the expression of VDR and LL-37 mRNA in peritoneal leukocytes increased synchronously in cirrhotic patients with SBP, indicating that vitamin D-VDR system and its downstream gene LL-37 are involved in the pathogenesis of SBP.