Objective: To analyze the expression of CD44 in non-alcoholic fatty liver disease (NAFLD) accompanied with hepatitis B virus (HBV) infection and its clinical significance. Methods: Blood sample of hospitalized patients with NAFLD, chronic hepatitis B, cirrhosis, and healthy population (control) was collected. The study was approved by the hospital ethics committee. Serum CD44 level and clinopathological characteristics were analyzed quantitatively by enzyme-linked immunosorbent-assay. Flow cytometry was used to analyze the proportion of CD44(+)T lymphocytes in patients with NAFLD and chronic hepatitis B. NAFLD model was prepared with high-fat diet to verify the abnormal expression of CD44. Results: Compared with the healthy control group, the expression of serum CD44 in the cirrhosis group, chronic hepatitis B group and NAFLD group was increased, and the difference between the groups were statistically significant (P < 0.01). NAFLD patients graded as mild or severe group were equally accompanied by hepatocyte injury, abnormal blood glucose, lipid or CD44. In NAFLD patients accompanied with HBV infection, serum CD44 concentrations were significantly higher in HBsAg, HBeAg and HBV DNA positive group than HBsAg, HBeAg and HBV DNA negative group (P < 0.01). The proportion of CD44(+)T lymphocytes in peripheral blood of NAFLD and chronic hepatitis B group were 78.2% ± 16.3% and 68.5% ± 20.9%, respectively, and both groups (NAFLD and chronic hepatitis B) were significantly higher than the healthy control group (46.5% ± 20.5%) (P < 0.05). The high-fat diet model confirmed that in rat liver tissues the CD44 was overexpressed with fat deposition accompanied with liver cell damage, especially remarkable in liver tissues containing carcinogens. Conclusion: The abnormal expression of CD44 in patients with NAFLD may be related to the malignant transformation of HBV-related liver disease.
目的： 分析非酒精性脂肪性肝病（NAFLD）伴乙型肝炎病毒（HBV）感染者CD44表达及其临床意义。 方法： 经医院伦理委员会同意，收集住院NAFLD、单纯慢性乙型肝炎和肝硬化患者血液，以健康体检人群作为对照，用酶联免疫吸附法定量分析血清CD44水平以及临床病理学特征；用流式细胞术分析NAFLD及慢性乙型肝炎患者CD44(+)T淋巴细胞比率；并以高脂饮食制备NAFLD模型验证CD44异常表达。用方差分析或校正t检验比较组间差异，用χ(2)检验比较组间阳性率。 结果： 与健康人群组比较，肝硬化组、慢性乙型肝炎组和NAFLD组血清CD44浓度表达升高，组间差异有统计学意义（P < 0.01）;轻度或重度NAFLD组患者均伴肝细胞损伤，血糖、血脂或CD44异常；在NAFLD患者伴HBV感染组中，HBsAg、HBeAg和HBV DNA阳性患者血CD44浓度均显著高于HBsAg、HBeAg和HBV DNA阴性组（P < 0.01）。外周血CD44(+)淋巴细胞比率，在NAFLD组为78.2%±16.3%，在慢性乙型肝炎组为68.5%±20.9%，两组均显著高于健康对照组（46.5%±20.5%）（P < 0.05）；高脂饮食模型证实鼠脂肪堆积的鼠肝组织中CD44过表达、伴肝细胞损伤，尤其在含诱癌剂的肝组织更显著。 结论： NAFLD患者CD44异常表达，可能与HBV相关肝病的恶性转化相关。.
Keywords: CD44; Chronic liver diseases; Model; Non-alcoholic fatty liver disease; T lymphocyte.