血清载脂蛋白B/A1值对慢性丙型肝炎肝纤维化(F≥2)的诊断价值  

Diagnostic value of serum apolipoprotein B/A1 ratio for hepatic fibrosis(F≥2) in chronic hepatitis C patients

作　　者：雷成多 李俊峰[2,3] 郑素军[2] 任艳[2] 赵景[2] 张景云[2] 段钟平[2] 

机构地区：[1]定西市第二人民医院传染科,甘肃定西743000 [2]首都医科大学附属北京佑安医院人工肝中心,北京100069 [3]兰州大学第一医院,兰州730000

出　　处：《临床肝胆病杂志》2015年第3期357-360,共4页Journal of Clinical Hepatology

基　　金："艾滋病和病毒性肝炎等重大传染病防治"科技重大专项基金资助项目(2013ZX10002002-006);北京高层次卫生人才项目(2011-3-083);佑安肝病艾滋病基金科研课题(BJYAH-2011-045);首都卫生发展科研专项项目(2011-2018-04)

摘　　要：目的探讨血清载脂蛋白B/A1值（apolipoprotein B/apolipoprotein A1,APOB/APOA1）与慢性丙型肝炎（CHC）肝纤维化的关系,及其对明显肝纤维化（≥F2）的鉴别能力。方法纳入来自甘肃省定西市的120例未经干扰素治疗的CHC患者,检测血清APOB、SPOA1以及其他肝功能指标。同时进行肝穿刺活组织检查,应用Metavir评分系统判断肝纤维化程度。计量资料组间比较采用t检验;计数资料组间比较采用Pearsonχ2检验。相关分析采用Spearman秩相关分析,同时给出受试者工作特征（ROC）曲线。结果 APOB/APOA1值与肝纤维化分期存在明显负相关性（r=-0.225,P=0.005）。发生和未发生明显肝纤维化（≥F2 vs F0~F1）的两组丙型肝炎患者中,APOB/APOA1值差异具有统计学意义（P=0.015）。ROC曲线结果显示,对于鉴别丙型肝炎明显肝纤维化的能力,APOB/APOA1值的曲线下面积达到0.63,敏感度和特异度分别达到93.8%和30.9%。结论血清APOB/APOA1值与丙型肝炎肝纤维化程度相关,且对于明显肝纤维化（≥F2）具有一定的鉴别能力。Objective To investigate the relationship between serum apolipoprotein B / A1（ APOB / APOA1） ratio and chronic hepatitis C（ CHC）- related hepatic fibrosis,and to assess the ability of serum APOB/APOA1 ratio to identify significant hepatic fibrosis（ ≥F2）.Methods A total of 120 interferon treatment- na？ ve CHC patients were selected from Dingxi,Gansu Province,China. Serum APOB,APOA1,and other clinical indicators of liver function were measured. Meanwhile,liver biopsies were performed,and the Metavir scoring system was employed to evaluate the stage of hepatic fibrosis. Continuous data were expressed as the mean ± standard deviation,and comparisons of the mean between groups were performed by t test. Categorical data were expressed as numerical value（ percentage）,and comparisons of the mean between groups were performed by Pearson χ2test. Correlation analysis was performed by Spearman’s rank correlation analysis,and the receiver operating characteristic（ ROC） curve was plotted. Results The APOB / APOA1 ratio was negatively correlated with the stage of liver fibrosis（ r =- 0. 225,P = 0. 005）. There was a significant difference in the APOB / APOA1 ratio between patients in the presence and absence of significant hepatic fibrosis（ ≥ F2 vs F0- F1,P = 0. 015）. Regarding the ability to distinguish CHC- related significant liver fibrosis,the ROC showed an area under the curve of APOB / APOA1 ratio up to 0. 63,with 93. 8% sensitivity and 30. 9%specificity. Conclusion There is an association between APOB / APOA1 ratio and the stage of CHC- related hepatic fibrosis. The APOB /APOA1 ratio has certain potential for identifying significant hepatic fibrosis in CHC patients.

关 键 词：肝炎 丙型 慢性 肝硬化 载脂蛋白B类 载脂蛋白A-1 

分 类 号：R512.63[医药卫生—内科学] R575.2[医药卫生—临床医学]