目的 通过研究葡萄糖激酶(GCK) mRNA、葡萄糖转运蛋白2(GLUT2)在慢性乙型重型肝炎(慢重肝)患者肝组织中的表达来初步探讨其在慢重肝糖代谢异常中的作用.方法 运用RT-PCR法测定10例慢重肝患者和10例肝硬化(CTP评分A级)患者肝脏GCK mRNA的表达；免疫组织化学方法检测上述10例慢重肝患者及10例正常对照肝组织GLUT2表达.两组间均数比较采用t检验,相关性采用Pearson相关分析.结果 慢重肝肝组织GCK mRNA表达低于肝硬化组,(1.13±0.11)vs(1.44 ±0.14),P＜0.05.慢重肝肝组织GCK mRNA水平与碳水化合物氧化率呈正相关(r=0.845,P＜0.01),与空腹血糖无明显相关性(r=0.03,P ＞0.05).慢重肝肝组织GLUT2表达减少,且分布在假小叶结节周围细胞.结论 肝脏GCK mRNA水平与糖氧化利用密切相关,GCK mRNA与GLUT2表达减少是慢重肝糖代谢障碍发生的机制之一.%Objective To evaluate the expression of glucokinase (GCK) mRNA and glucose transporter-2 (GLUT2) in the liver tissues of patients with severe chronic hepatitis B and to preliminarily investigate their roles in abnormal glucose metabolism among patients with severe chronic hepatitis B.Methods The expression of GCK mRNA in the liver tissues of 10 patients with severe chronic hepatitis B and 10 patients with liver cirrhosis (Child-Turcotte-Pugh grade A) was evaluated by RT-PCR.The expression of GLUT2 in the liver tissues of the above 10 patients with severe chronic hepatitis B and 10 normal controls was evaluated by immunohistochemistry.The t-test was used for mean comparison between groups; the Pearson correlation test was used for correlation analysis.Results The expression level of GCK mRNA in liver tissue was significantly lower in the patients with severe chronic hepatitis B than in those with liver cirrhosis (1.13 ±0.11 vs 1.44 ±0.14,P ＜0.05).In the patients with severe chronic hepatitis B,the level of GCK mRNA in liver tissue had a positive correlation with the oxidation rate of carbohydrates (r =0.845,P ＜ 0.01),but it had no correlation with fasting blood glucose (r =0.03,P ＞ 0.05).The expression of GLUT2was reduced in the liver tissues of patients with severe chronic hepatitis B,and it was distributed in the hepatic cells around pseudolobuli (nodules).Conclusion The level of GCK mRNA is closely related to the oxidation of carbohydrates.The decreased expression of GCK mRNA and GLUT2 is one of the mechanisms of abnormal glucose metabolism in patients with severe chronic hepatitis B.
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