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目的探讨肝细胞凋亡及凋亡相关基因Caspase-3、Bcl-2在慢性乙型重型肝炎(慢重肝)发生发展机制中的作用。方法选择慢重肝肝组织标本68例(慢重肝组),正常肝组织标本20例(对照组)。采用原位末端转移酶标记技术(terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling,TUNEL)技术和免疫组织化学法检测2组肝组织中Cas-pase-3和Bcl-2的表达及肝细胞凋亡情况。结果慢重肝组凋亡指数的平均值为41.6±4.9,而在正常对照组肝组织中,未见到TUNEL阳性表达的肝细胞,2组差异有统计学意义。慢重肝组的肝组织中Caspase-3蛋白阳性表达程度明显高于对照组(P<0.05),而Bcl-2蛋白阳性表达程度明显低于对照组。Spearman相关分析发现,慢重肝组的肝组织中肝细胞凋亡指数与Caspase-3表达之间呈正相关(r=0.592,P<0.01),与Bcl-2表达之间呈负相关(r=-0.461,P<0.05)。结论肝细胞凋亡在慢重肝的发生过程中起重要作用,而Caspase-3和Bcl-2均参与了慢重肝的肝细胞凋亡过程。
Objective To investigate the role of hepatocellular apoptosis and the apoptosis-related genes Caspase-3 and Bcl-2 in the pathogenesis of chronic severe hepatitis B (chronic severe hepatitis). Methods Sixty-eight patients with chronic liver disease (chronic severe hepatitis group) and 20 normal liver tissues (control group) were selected. The expression of Cas-pase-3 and Bcl-2 in liver tissue and the changes of hepatocyte apoptosis were detected by TUNEL and immunohistochemistry in the endometriosis group Death situation. Results The average apoptotic index in chronic severe hepatitis group was 41.6 ± 4.9, while in the normal control group, no TUNEL positive hepatocytes were found, the difference between the two groups was statistically significant. The positive expression of Caspase-3 protein in liver tissue of chronic severe hepatitis group was significantly higher than that in control group (P <0.05), but the positive expression of Bcl-2 protein was significantly lower than that in control group. Spearman correlation analysis showed that there was a positive correlation between hepatocyte apoptosis index and Caspase-3 expression in chronic liver disease group (r = 0.592, P <0.01), but negatively correlated with Bcl-2 expression (r = -0.461, P <0.05). Conclusion Apoptosis of hepatocytes plays an important role in the pathogenesis of chronic severe hepatitis, while Caspase-3 and Bcl-2 are involved in the process of hepatocellular apoptosis.