sCD163和铁蛋白在HBV相关慢加急性肝功能衰竭中的表达及其临床意义  

The expression and clinical significances of sCD163 and ferritin in the patients with HBV related acute-on-chronic liver failure

作　　者：李珊珊[1] 李璐[1] 张丹丹[1] 仵永枫 丁美[1] 段钟平[1] 陈煜[1] 

机构地区：[1]首都医科大学附属北京佑安医院人工肝中心,100069

出　　处：《肝脏》2014年第10期733-735,762,共4页Chinese Hepatology

基　　金：十二五重大专项课题资助项目(2012ZX10002004-006;2012ZX10004904-003-001;2013ZX10002002-006-001);北京市"卫生系统高层次卫生技术人才"资助项目(2013-3-071);北京市科技计划课题(Z131100004613030)

摘　　要：目的研究HBV相关慢加急性肝功能衰竭(HBV-ACLF)患者血浆中可溶性CD163(sCD163)和铁蛋白水平,分析其与患者病情、预后的关系。方法选择HBV-ACLF患者30例、乙型肝炎肝硬化25例、慢性乙型肝炎18例以及健康对照15例,采用ELISA方法检测血浆中sCD163和铁蛋白水平。结果 HBV-ACLF组血浆中sCD163和铁蛋白水平均明显高于肝硬化组、慢性乙型肝炎组及健康对照组[sCD163:(123±43)比(76±33)、(58±19)、(35±15)ng/mL,均P<0.05;铁蛋白:(2 714±1 896)比(505±722)、(833±801)、(106±58)ng/mL,均P<0.05]。肝衰竭发展到晚期时sCD163和铁蛋白水平均较早、中期明显增高[sCD163:(162±44)比(104±40)、(108±24)ng/mL,均P<0.05);铁蛋白:(4 154±2 122)比(1 746±1 047)、(2 416±1 713)ng/mL,均P<0.05]。HBV-ACLF死亡组中sCD163和铁蛋白水平均高于存活组[sCD163:(140±42)比(101±36)mg/mL,(t=-2.719,P=0.01);铁蛋白:(3 568±2 007)比(1 598±957)ng/mL,(t=-3.547,P=0.001)]。经受试者工作特征曲线(ROC)分析,sCD163、铁蛋白评估HBV-ACLF患者3个月内死亡所对应的曲线下面积(AUC)分别为0.803、0.844。结论 sCD163和铁蛋白可作为HBV-ACLF病情严重程度及预后评估的重要参考指标。Objective To investigate the expression and clinical significances of sCD163 and ferritin in HBV related acute-on-chronic liver failure（HBV-ACLF）patients. Methods The expression of sCD163 and ferritin of 30 HBV-ACLF patients,25 liver cirrhosis patients（LC group）,18 chronic hepatitis B patients （CHB group）and 15 normal persons （normal group）were detected by ELISA. Results The expressions of sCD163 and ferritin in HBV-ACLF group were significantly higherthanthoseinLC,CHBandnormalgroup[sCD163（ng/ml）：123±43vs76±33,58±19,35±15（P= 0.007）;ferritin（ng/ml）：2714±1896vs505±722,833±801,106±58（P= 0.004）;P〈0.05].AttheadvancedstageofHBV-ACLF,the concentrations of sCD163 and ferritin were significantly higher than those in the nonage and metaphase stage [sCD163：162±44vs104±40,108±24（P= 0.01）;ferritin：4154±2122vs1746±1047,2416±1713（P= 0.001）;P〈0.05]. Besides,the expressions of sCD163 and ferritin in non-survival group were higher than survival group[sCD163：140±42vs101±36（t= -2.719,P= 0.01）;ferritin：3568±2007vs1598±957（t= -3.547,P= 0.001）;P〈0.05].To investigate the value of sCD163 and ferritin of prognosis in HBC-ACLF patients＆#39;prognosis in 3 months,receiver operating characteristic curve（ROC）analysis was conducted. The area under curve（AUC）were 0.803 and 0.844,respectively. Conclusion sCD163 and ferritin may serve as important evaluating indicator of disease severity and prognosis in HBV-ACLF patients .

关 键 词：HBV相关慢加急性肝衰竭 sCD163 铁蛋白 sCD163 

分 类 号：R575.3[医药卫生—消化系统]