miR-223、miR-324-5p与慢性乙肝肝纤维化的相关性及其临床诊断价值  

Correlation of miR-223 and miR-324-5p expression with liver fibrosis caused by chronic hepatitis B infection and its clinical diagnostic value

作　　者：杨荔[1] 王海霞[2] 孟小芬[1] 田银娣 薛云珠[1] 白小龙[1] 逯云[1] 路燕[1] 雷焕勤 孙蕾[1] 卢乐 YANG Li;WANG Haixia;MENG Xiaofen;TIAN Yindi;XUE Yunzhu;BAI Xiaolong;LU Yun;LU Yan;LEI Huanqin;SUN Lei;LU Le(Department of General Surgery,Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China;Department of Surgery,Second Affiliated Hospital of Xi’an Medical University;Department of Infectious Disease,Second Affiliated Hospital of Xi’an Jiaotong University)

机构地区：[1]西安交通大学第二附属医院普通外科,西安710004 [2]西安医学院第二附属医院外科 [3]西安交通大学第二附属医院感染科

出　　处：《山西医科大学学报》2021年第1期102-106,共5页Journal of Shanxi Medical University

基　　金：陕西省自然科学基础研究计划项目(2018JM7034)。

摘　　要：目的探讨miR-223、miR-324-5p与慢性乙肝肝纤维化的关系,以及其对慢性乙肝感染及肝纤维化程度的临床诊断价值。方法选取本院2018年1月至2019年12月收治的80例慢性乙型肝炎患者为乙肝组,80例健康者为对照组,采用RT-PCR法检测所有受试者血清中miR-223、miR-324-5p相对表达水平。根据肝组织活检Metavir评分标准将乙肝组分为无肝纤维化组(n=20)和肝纤维化组(n=60),采用二元Logistics回归分析miR-223、miR-324-5p与乙型肝炎肝纤维化的关系。随后再将乙肝组分为轻中度肝纤维化组(n=44)和重度肝纤维化组(n=36),绘制ROC曲线研究miR-223、miR-324-5p相对表达水平对乙型肝炎病毒感染和重度肝纤维化的诊断效能。结果乙肝组患者血清中miR-223和miR-324-5p水平均显著高于对照组,差异均有统计学意义(P<0.05)。肝纤维化组患者血清中miR-223和miR-324-5p水平均显著高于无肝纤维化组,差异均有统计学意义(P<0.05)。二元Logistics回归分析提示miR-223水平是乙型肝炎患者肝纤维化的危险因素。重度肝纤维化患者血清中miR-223和miR-324-5p水平均显著高于轻中度肝纤维化患者,差异均有统计学意义(P<0.05)。在乙型肝炎的诊断中,miR-223、miR-324-5p及两者联合的ROC曲线下面积分别为0.855,0.818,0.879,均有统计学意义(P<0.05)。在重度肝纤维化的诊断中,miR-223、miR-324-5p及两者联合的ROC曲线下面积分别为0.792,0.676,0.830,均有统计学意义(P<0.05)。诊断效能统计结果显示,miR-223和miR-324-5p联合检测诊断乙型肝炎的准确度、特异度均优于各指标单独检测;miR-223和miR-324-5p联合检测诊断重度肝纤维化的准确度、敏感度均优于各指标单独检测。结论miR-223水平可能是乙型肝炎患者肝纤维化的危险因素,具有进一步研究价值。外周血miR-223和miR-324-5p水平可有效反映乙型肝炎病毒的感染情况和肝纤维化程度,同时监测两者表达水平,有助于对乙型�Objective To investigate the relationship between miR-223,miR-324-5p and liver fibrosis of chronic hepatitis B,and the clinical value of miR-223 and miR-324-5p in diagnosis of chronic hepatitis B infection and liver fibrosis.Methods Eighty patients with chronic hepatitis B admitted to our hospital from January 2018 to December 2019 were selected as hepatitis B group,and 80 healthy subjects were selected as control group,and then RT-PCR was used to detect the relative expression levels of miR-223 and miR-324-5p in serum of all subjects.According to Metavir score of the liver biopsy,the patients with hepatitis B infection were divided into non-fibrosis group(n=20)and liver fibrosis group(n=60),and then binary Logistic regression was used to analyze the relationships between miR-223,miR-324-5p and liver fibrosis caused by hepatitis B infection.The hepatitis B patients were also divided into mild and moderate liver fibrosis group(n=44)and severe liver fibrosis group(n=36),and then ROC curve was drawn to study the diagnostic efficacy of miR-223 and miR-324-5p in the diagnosis of hepatitis B virus infection or severe liver fibrosis.Results The serum levels of miR-223 and miR-324-5p in hepatitis B group were significantly higher than those in control group(P<0.05).The serum levels of miR-223 and miR-324-5p in the patients with liver fibrosis were significantly higher than those in the patients without liver fibrosis(P<0.05),while binary Logistic regression analysis showed that miR-223 level was a risk factor for liver fibrosis in patients with hepatitis B infection.The serum levels of miR-223 and miR-324-5p in the patients with severe liver fibrosis were significantly higher than those in the patients with mild and moderate liver fibrosis(P<0.05).In the diagnosis of hepatitis B,the area under ROC curve of miR-223,miR-324-5p and their combination was respectively 0.855,0.818 and 0.879,which were statistically significant(P<0.05).In the diagnosis of severe liver fibrosis,the area under ROC curve of miR-223,miR-324-5p and

关 键 词：慢性乙型肝炎 肝纤维化 miR-223 miR-324-5p Metavir评分 

分 类 号：R575[医药卫生—消化系统]