血清五聚蛋白3水平对慢性丙型肝炎肝纤维化的诊断价值  

Diagnostic value of serum pentraxin 3 level in liver fibrosis of chronic hepatitis C

作　　者：张茜茜 张帆[2] 王登芹[3] 万磊 随萍[1] 赵士兴 Zhang Qianqian;Zhang Fan;Wang Dengqin;Wan Lei;Sui Ping;Zhao Shixing(Department of Diagnostics,Jining Medical University,Jining 272000,China;Department of Gastroenterology,Affiliated Hospital of Jining Medical University,Jining 272000,China;Department of Clinical Medical Skills Center,Jining Medical University,Jining 272000,China;Department of Neurobiology,Jining Medical University,Jining 272000,China;Department of Intensive Care Unit,Affiliated Hospital of Jining Medical University,Jining 272000,China)

机构地区：[1]济宁医学院诊断学教研室,山东济宁272000 [2]济宁医学院附属医院消化内科,山东济宁272000 [3]济宁医学院临床医学技能中心,山东济宁272000 [4]济宁医学院神经生物学教研室,山东济宁272000 [5]济宁医学院附属医院重症医学科,山东济宁272000

出　　处：《中国临床实用医学》2020年第2期1-6,共6页China Clinical Practical Medicine

基　　金：山东省自然科学基金(ZR2017BH056);山东省自然科学基金(ZR2017PC019)。

摘　　要：目的:探究慢性丙型肝炎(CHC)患者血清五聚蛋白3(PTX3)的表达水平,并分析PTX3对肝纤维化分期诊断的临床意义。方法:选取2016年9月至2019年10月济宁医学院附属医院消化内科收治的178例CHC患者为CHC组,男92例,女86例,年龄(42.28±13.70)岁,年龄范围为24~67岁。另选取同时期体检的30例健康者作为健康组,男19例,女11例,年龄(43.05±12.88)岁,年龄范围为22~66岁。应用酶联免疫吸附法(ELISA)检测血清白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、透明质酸、层黏连蛋白(LN)、Ⅲ型前胶原肽(PⅢP)、Ⅳ型胶原蛋白(CⅣ)及PTX3的水平。结果:CHC组血清IL-2水平[(97.27±26.39)pg/ml]显著低于健康组[(146.4±31.02)pg/ml],IL-6[(72.65±10.26)pg/ml]、TNF-α水平[(32.58±6.75)pg/ml]均显著高于健康组[(36.61±11.05)pg/ml、(11.13±2.34)pg/ml],差异有统计学意义(P<0.05);CHC患者的血清透明质酸[(255.22±69.98)μg/L]、LN[(173.36±33.02)μg/L]、PⅢP[(163.23±40.89)μg/L]、CⅣ[(227.20±72.77)μg/L]、PTX3水平[(4.47±1.20)μg/L]均显著高于健康组[(74.97±15.73)μg/L、(78.36±12.82)μg/L、(71.95±6.10)μg/L、(44.86±2.64)μg/L、(0.37±0.11)μg/L],差异有统计学意义(P<0.05);经Pearson相关性分析,血`清PTX3水平与IL-2呈显著负相关,而与IL-6、TNF-α、透明质酸、LN、PⅢP、CⅣ等均呈显著正相关(P<0.05);CHC组不同肝纤维化程度患者血清PTX3水平上差异显著(P<0.05),且CHC患者病理学结果显示,F1期为39例、F2期为61例、F3期为33例、F4期为45例。4组CHC患者在PTX3水平上比较,F4期>F3期>F2期>F1期,差异有统计学意义(P<0.05);诊断价值采用ROC曲线结果显示F1期的诊断以PTX3取2.070μg/L诊断效果最佳,AUC为0.628,特异度为0.921,灵敏度为0.402;F2期的诊断以PTX3取2.430μg/L诊断效果最佳,AUC为0.661,特异度为0.770,灵敏度为0.615;F3期的诊断以PTX3取3.245μg/L诊断效果最佳,AUC为0.789,特异度为0.727,灵敏度为0.872;F4期的诊�Objective To investigate the expression level of serum pentraxin 3(PTX3)in patients with chronic hepatitis C(CHC),and to analyze the clinical significance of PTX3 in the staging diagnosis of liver fibrosis.Methods From September 2016 to October 2019,178 patients with CHC were enrolled in the Department of Gastroenterology,Affiliated Hospital of Jining Medical College,including 92 males and 86 females,aged(42.28±13.70)years old and ranging in age from 24 to 67 years old.Another 30 healthy persons in the same period were selected as the healthy group,including 19 males and 11 females,aged(43.05±12.88)years old and ranging in age from 22 to 66 years old.The serum levels of interleukin-2(IL-2),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),hyaluronic acid,laminin(LN),procollagen typeⅢpeptide(PⅢP),collagen typeⅣ(CⅣ)and PTX3 were detected by enzyme-linked immunosorbent assay(ELISA).Results Serum levels of IL-2[(97.27±26.39)pg/ml]in the CHC group were significantly lower than those in the healthy group[(146.4±31.02)pg/ml],levels of IL-6[(72.65±10.26)pg/ml]and TNF-α[(32.58±6.75)pg/ml]were significantly higher than those in the healthy group[(36.61±11.05)pg/ml and(11.13±2.34)pg/ml],with statistically significant differences(P<0.05).CHC patients serum hyaluronic acid[(255.22±69.98)μg/L],LN[(173.36±33.02)μg/L],PⅢP[(163.23±40.89)μg/L],CⅣ[(227.20±72.77)μg/L],PTX3 level[(4.47±1.20)μg/L]were significantly higher than that of healthy group[(74.97±15.73)μg/L,(78.36±12.82)μg/L,(71.95±6.10)μg/L,(44.86±2.64)μg/L,(0.37±0.11)μg/L],(P<0.05).The Pearson correlation analysis showed that serum levels of PTX3 had negative correlation with IL-2,and had positive correlation with IL-6,TNF-α,hyaluronic acid,LN,PⅢP and CⅣ(P<0.05).The serum PTX3 level of patients with different degrees of liver fibrosis in the CHC group was significantly different(P<0.05),and the pathological results of CHC patients showed that 39 patients were in stage F1,61 were in stage F2,33 were in stage F3 and 45 were in

关 键 词：慢性丙型肝炎 五聚蛋白3 肝纤维化 

分 类 号：R575[医药卫生—消化系统] R51[医药卫生—内科学]