非酒精性脂肪肝病情程度与血清CK-18及肝纤维化指标的相关性  

Correlation Analysis of Degree of Nonalcoholic Fatty Liver Disease with Serum CK-18 and Liver Fibrosis Index

作　　者：张蓓琳[1] 黄玉伟[1] 符策月[1] 蔡雷鸣[1] 王斌[1] ZHANG Beilin;HUANG Yuwei;FU Ceyue;CAI Leiming;WANG Bin(Department of Gastroenterology,Baoshan Branch,Shanghai First People′s Hospital,Shanghai 200071,China)

机构地区：[1]上海市第一人民医院宝山分院消化内科,上海200071

出　　处：《医学综述》2020年第12期2474-2478,共5页Medical Recapitulate

摘　　要：目的分析不同病情程度非酒精性脂肪肝(NAFLD)患者血清中细胞角蛋白18(CK-18)、肝纤维化指标的表达水平及其相关性。方法选择2015年1月至2018年8月上海市第一人民医院宝山分院收治的100例NAFLD患者作为研究对象,按照病情严重程度不同分为轻度组(37例)、中度组(33例)、重度组(30例)。纳入同期健康志愿者30名作为对照组。采用酶联免疫吸附试验法检测全部受试者的血清CK-18水平,采用化学发光法检测血清中的肝纤维化指标[Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)、层粘连蛋白(LN)、透明质酸(HA)]。比较各组血清CK-18、肝纤维化指标表达水平,以及NAFLD病情程度与CK-18、肝纤维化指标的相关性。结果各组血清CK-18和肝纤维化指标(PCⅢ、PCⅢ、CⅣ、LN、HA)比较差异有统计学意义(P <0. 01)。NAFLD轻度、中度、重度组血清CK-18高于对照组[(9. 1±3. 3) ng/L、(12. 0±5. 0) ng/L、(13. 7±5. 3) ng/L比(3. 9±1. 1) ng/L],PCⅢ高于对照组[(116. 2±26. 8)μg/L、(128. 2±29. 6)μg/L、(132. 7±47. 9)μg/L比(94. 9±18. 0)μg/L],CⅣ高于对照组[(57. 8±12. 1)μg/L、(73. 3±16. 9)μg/L、(86. 2±23. 9)μg/L比(53. 8±13. 2)μg/L],LN高于对照组[(98. 6±27. 5)μg/L、(112. 1±25. 2)μg/L、(134. 5±22. 1)μg/L比(83. 9±18. 5)μg/L],HA高于对照组[(82. 6±17. 4)μg/L、(91. 2±18. 7)μg/L、(122. 4±25. 8)μg/L比(79. 4±12. 4)μg/L](P <0. 05),NAFLD中度和重度组高于轻度组,NAFLD重度组高于中度组(P <0. 05)。Spearman等级相关分析结果显示,NAFLD病情程度与CK-18、PCⅢ、CⅣ、LN、HA均呈正相关(r_s=0. 618,P <0. 001;r_s=0. 215,P=0. 027;r_s=0. 506,P=0. 004;r_s=0. 579,P <0. 001;r_s=0. 528,P=0. 001)。结论 NAFLD病情程度与血清CK-18及肝纤维化指标具有相关性,NAFLD均伴有血清CK-18及肝纤维化指标升高。Objective To investigate the expression level of cytokeratin 18(CK-18)and liver fibrosis index in sera of patients with non-alcoholic fatty liver(NAFLD)of different degrees and analyze their correlation.Methods 100 NAFLD patients in Baoshan Branch of Shanghai First People′s Hospital from Jan.2015 to Aug.2018 were included as the observation objects.According to the severity of illness,the patients were grouped:a mild group(37 cases),a moderate group(33 cases),a severe group(30 cases).And 30 healthy volunteers during the same period were enrolled as a control group.Enzyme linked immunosorbent assay was used to measure the serum CK-18 content,and the indexes of liver fibrosis[procollagen typeⅢ(PCⅢ),collagen typeⅣ(CⅣ),laminin(LN),hyaluronic acid(HA)]were detected by chemiluminescence.The levels of serum CK-18 and liver fibrosis indexes of different groups were compared.The correlations between NAFLD disease degree,CK-18 and liver fibrosis indexes were analyzed.Results The serum CK-18 and liver fibrosis indexes(PCⅢ,CⅣ,LN,HA)in each group were significantly different(P<0.01).the serum CK-18 of the NAFLD mild,moderate and severe group were higher than that of the control group[(9.1±3.3)ng/L,(12.0±5.0)ng/L,(13.7±5.3)ng/L vs(3.9±1.1)ng/L];the PCⅢof the NAFLD mild,moderate and severe group were higher than that of the control group[(116.2±26.8)μg/L,(128.2±29.6)μg/L,(132.7±47.9)μg/L vs(94.9±18.0)μg/L];the CⅣof the NAFLD mild,moderate and severe group were all higher than that of the control group[(57.8±12.1)μg/L,(73.3±16.9)μg/L,(86.2±23.9)μg/L vs(53.8±13.2)μg/L](P<0.05).LN of the NAFLD mild,moderate and severe group were higher than that of the control group[(98.6±27.5)μg/L,(112.1±25.2)μg/L,(134.5±22.1)μg/L vs(83.9±18.5)μg/L];HA of the NAFLD mild,moderate and severe group were higher than that of the control group[(82.6±17.4)μg/L,(91.2±18.7)μg/L,(122.4±25.8)μg/L vs(79.4±12.4)μg/L](P<0.05),and the NAFLD moderate and severe group higher than the mild group,the NAFLD sever

关 键 词：非酒精性脂肪肝 细胞角蛋白-18 肝纤维化指标 脂肪肝程度 

分 类 号：R446.62[医药卫生—诊断学]