ICG-R15与乙型肝炎e抗原阳性/阴性慢性乙型肝炎患者肝组织改良Scheuer评分的相关性分析  

Correlation analysis between ICG-R15 and modified Scheuer score in liver tissues of patients with hepatitis B e antigen-positive/negative chronic hepatitis B

作　　者：张明明[1] 张思薇 胡璇 包飞云 裴志燕 刘元元[1] 麻爱娣 张岭漪[1] Zhang Mingming;Zhang Siwei;Hu Xuan;Bao Feiyun;Pei Zhiyan;Liu Yuanyuau;Ma Aidi;Zhang Lingyi(Department of Hepatology,Second Hospital of Lanzhou University,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院肝病科,730030

出　　处：《中华肝脏病杂志》2021年第6期565-570,共6页Chinese Journal of Hepatology

基　　金：吴阶平医学基金会临床科研专项资助基金 (LDWJPMF-104-002);兰州大学第二医院"萃英科技创新"计划项目 (CY2018-BJ17)。

摘　　要：目的分析吲哚菁绿15 min滞留率(ICG-R15)与乙型肝炎e抗原阳性/阴性[HBeAg(+)/HBeAg(-)]慢性乙型肝炎(CHB)患者肝组织改良Scheuer评分的相关性,以探索吲哚菁绿清除试验(ICGCT)在判断CHB肝病进展方面的应用价值。方法收集407例血清丙氨酸转氨酶(ALT)正常或轻度升高[<2倍正常值上限(ULN)]且经改良Scheuer评分的HBeAg(+)/HBeAg(-)CHB住院患者,分为轻度肝病组(M组,131例,改良Scheuer评分<G2S2)和进展肝病组(A组,276例,改良Scheuer评分≥G2和/或S2);亚组分为:HBeAg(+)-M组、HBeAg(-)-M组、HBeAg(+)-A组、HBeAg(-)-A组。回顾性分析ICG-R15与各组间改良Scheuer评分的相关性。对数据采用t检验、U检验,相关分析采用Spearman等级相关检验。结果临床基本特征:407例血清ALT正常或轻度升高的CHB患者中HBeAg(+)CHB 171例,HBeAg(-)CHB 236例;HBeAg(+)CHB患者血清HBV DNA基线均值[(6.06±1.95)log10IU/ml]高于HBeAg(-)CHB[(3.60±1.37)log10IU/ml,P=0.000]。纳入患者ICG-R15检测特征:(1)ICG-R15基线均值在HBeAg(+)CHB和HBeAg(-)CHB两组患者间差异无统计学意义,且基本在正常值范围(<10%);(2)ICG-R15基线均值在各亚组间比较显示,HBeAg(+)-A组/HBeAg(-)-A组患者分别高于HBeAg(+)-M组/HBeAg(-)-M组患者,且差异具有统计学意义(P=0.003,P=0.048)。纳入患者ICG-R15与改良Scheuer评分的相关性分析:(1)ICG-R15与HBeAg(+)/HBeAg(-)CHB两组患者改良Scheuer评分中炎症活动分级(G)均分别呈弱正相关性(r=0.237,P=0.002;r=0.244,P=0.000);(2)ICG-R15与HBeAg(+)/HBeAg(-)CHB两组患者改良Scheuer评分中纤维化分期(S)均分别呈弱正相关性(r=0.254,P=0.001;r=0.225,P=0.001)。ICG-R15对纳入患者肝组织学进展严重程度的预测价值:当ICG-R15截断值取5.1%时,基于ICG-R15预测HBeAg(+)/HBeAg(-)CHB患者M组进展至A组的受试者工作特征曲线下面积为0.601(P=0.001)。结论ICG-R15与ALT正常或轻度升高的HBeAg(+)/HBeAg(-)CHB患者肝组织改良Scheuer评分具有一定的正相关性;ICG-R15的截�Objective To analyze the correlation between indocyanine green retention rate at 15 minutes(ICG-R15)and modified Scheuer score in liver tissues of patients with hepatitis B e antigen-positive/negative chronic hepatitis B(CHB),and further explore the indocyanine green clearance test(ICGCT)applied value in judging the progress of CHB-related liver disease.Methods 407 HBeAg(+)/HBeAg(-)CHB inpatients with normal or slightly elevated serum alanine aminotransferase(ALT)[<2 times the upper limit of normal(ULN)]and modified Scheuer score were collected,and divided into mild liver disease group(M group,131 cases,modified Scheuer score<G2S2)and progressive liver disease group(A group,276 cases,modified Scheuer score≥G2 and/or S2).Furthermore,the groups were sub-divided into HBeAg(+)-M group,HBeAg(-)-M group,HBeAg(+)-A group and HBeAg(-)-A group.The correlation between ICG-R15 and modified Scheuer score was analyzed retrospectively.The data were analyzed by SPSS 24.0 software.Results Basic clinical characteristics:Among the 407 CHB cases with normal or mildly elevated serum ALT,171 were HBeAg(+)CHB and 236 were HBeAg(-)CHB.The baseline mean serum HBV DNA was higher in HBeAg(+)CHB patients[(6.06±1.95)log10IU/ml]than HBeAg(-)CHB patients[(3.60±1.37)log10IU/ml(P=0.000)].Included patients ICG-R15 detection characteristics:(1)The baseline mean value of ICG-R15 was not statistically significant between the two groups of HBeAg(+)CHB and HBeAg(-)CHB,and was basically within the normal range(<10%);(2)Comparison of ICG-R15 baseline mean value among the subgroups showed that the patients in the HBeAg(+)-A group/HBeAg(-)-A group were higher than the HBeAg(+)-M group/HBeAg(-)-M group patients,and the difference was statistically significant(P=0.013/P=0.000).Included patients’correlation analysis between ICG-R15 and modified Scheuer score:(1)ICG-R15 and modified Scheuer score had shown weak positive correlation with inflammatory activity grade(g)in HBeAg(+)/HBeAg(-)CHB(r=0.237,P=0.002);r=0.244,P=0.000);(2)There was a weak positive

关 键 词：慢性乙型肝炎 丙氨酸转氨酶 吲哚菁绿15 min滞留率 改良Scheuer评分 

分 类 号：R512.62[医药卫生—内科学] R446.6[医药卫生—临床医学]