乙型病毒性肝炎肝硬化患者血清网膜素和脂联素水平测定的临床意义  

Clinical significance of serum levels of omentin and adiponectin in patients with viral hepatitis B cirrhosis

作　　者：魏新亮[1] 魏思忱[1] 田树英[1] 孔郁[1] 王卫卫[1] 姜红玉[1] WEI Xin liang WEI Sichen TIAN Shuying KONG Yu WANG Weiwei JIANG Hongyu(Second Department of Gastroenterology, Cangzhou Central Hospital, Hebei Province, Cangzhou 061001, China)

机构地区：[1]河北省沧州市中心医院消化内二科,061001

出　　处：《疑难病杂志》2017年第2期156-159,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：河北省沧州市科学技术研究与发展指导计划项目(141302056)

摘　　要：目的测定乙型病毒性肝炎肝硬化患者血清网膜素、脂联素水平,分析其与胰岛素、Child-Pugh分级、肝脏生化指标及血脂间的关系。方法选择2014年3月—2015年3月河北省沧州市中心医院消化内二科住院的乙型病毒性肝炎肝硬化患者67例(观察组),Child-Pugh分级A级20例,B级24例,C级23例,另选择同期健康体检者30例为健康对照组,分析其血清网膜素、脂联素及相关的临床生化指标变化特点。结果观察组患者血清网膜素、脂联素水平明显高于健康对照组(t=3.61、6.58,P=0.00),观察组内A、B、C 3级间网膜素、脂联素水平差异无统计学意义(F=0.640、0.530,P>0.05),观察组患者血清网膜素、脂联素水平与HOMA-IR、胰岛素水平均无明显相关性(r=-0.027,P=0.864,r=-0.125,P=0.420;r=-0.057,P=0.714,r=0.024,P=0.876),网膜素水平与脂联素、白蛋白呈正相关(r=0.406,P=0.007,r=0.351,P=0.020),脂联素水平与HDL-C呈正相关(r=0.313,P=0.039)。血清网膜素、脂联素预测乙型病毒性肝炎肝硬化ROC曲线下面积分别为0.768、0.908,cut-off值分别为931.08 ng/L,809.28μg/L。结论肝硬化时网膜素、脂联素升高,可作为预测乙型病毒性肝炎肝硬化的指标,脂联素诊断价值更高,但均不能作为肝功能严重程度的指标。Objective To determine the level of serum omentin and adipouectin in patients with viral hepatitis B cirrhosis,and to analyze the relationship between the levels of insulin,Child-Pugh,liver biochemical indexes and blood lipids.Methods From March 2014 to March 2015,in Cangzhou Central Hospital of Hebei Province Department of Gastroenterology,67 cases of hepatitis B cirrhosis patients（observation group） were divided as follow;20 cases of Child Pugh grade A,24 eases of grade B,23 cases of grade C,the other 30 cases of healthy people were selected as healthy control group,analysis of the serum omentin,adipouectin and related clinical and biochemical parameters changes.Results Serum omentin and adipouectin levels were significantly higher than the control group（t =3.61,t =6.58,P =0.00）.the observation group had no statistical significance in A,B,C 3 levels between omentin and adipouectin level differences（F =0.640,F =0.530,P〉0.05）,serum adipouectin,visfatin levels and HOMA IB and insulin levels were not significantly correlated（r =-0.027,P=0.864,r =-0.125,P=0.420;r =-0.057.P =0.714,r =0.024,P =0.876）,were positively correlated with adiponcctin,and omentin levels of albumin（r =0.406,P =0.007,r =0.351,P =0.020）,adiponectin was positively related to HDL-C（r =0.313,P =0.039）.The area of BOC curve in serum of patients with hepatitis B cirrhosis was0.768 and,and the cut value of off was about 931.08 ng/L and 809.28 μg/L,respectively.Conclusion The level of serum omentin and adiponectin in patients with liver cirrhosis can be used as an indicator to predict the incidence of hepatitis B cirrhosis.The value of adiponectin is higher,hut it can not be used as an indicator of the severity of liver function.

关 键 词：肝硬化 乙型肝炎 网膜素 脂联素 

分 类 号：R512.62[医药卫生—内科学]