红细胞分布宽度、miR-130a与乙型肝炎肝硬化并发消化道出血及病情进展的关联性  

Correlation between the red blood cell distribution width and miR-130a and hepatitis B liver cirrhosis complicated with gastrointestinal bleeding and disease progression

作　　者：孙喜斌[1] 张玉虹[1] 左路广 贾倩[1] 连晶晶[1] 冯博[1] 高咏梅[1] 张斌[1] SUN Xibin;ZHANG Yuhong;ZUO Luguang;JIA Qian;LIAN Jingjing;FENG Bo;GAO Yongmei;ZHANG Bin(The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院检验科,河北张家口075000

出　　处：《国际检验医学杂志》2021年第20期2462-2467,2472,共7页International Journal of Laboratory Medicine

基　　金：河北省2017年度医学科学研究课题(20170806)。

摘　　要：目的探讨红细胞分布宽度(RDW)、微小RNA-130a(miR-130a)与乙型肝炎(下称乙肝)肝硬化并发消化道出血(GB)及病情进展的关联性。方法选取2017年1月至2020年9月该院204例乙肝肝硬化患者,根据有无GB分为GB组(n=71)与非GB组(n=133)。比较两组天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、γ-谷氨酰转肽酶(GGT)、RDW、miR-130a表达,分析RDW、miR-130a与肝功能指标的相关性及对乙肝肝硬化并发GB的诊断效能,同时比较GB组不同病情程度患者临床资料、肝功能指标、RDW、miR-130a表达,探究乙肝肝硬化并发GB病情程度的影响因素。结果GB组AST、ALT、GGT、RDW水平均高于非GB组,miR-130a低于非GB组,差异有统计学意义(P<0.05)。GB患者RDW与AST、ALT、GGT呈正相关关系,miR-130a表达与AST、ALT、GGT呈负相关关系(P<0.05)。受试者工作特征(ROC)曲线显示,RDW、miR-130a表达联合诊断乙肝肝硬化并发GB的曲线下面积(AUC)最大,为0.771,灵敏度、特异度分别为77.46%、68.42%。Child-Pugh分级、脾脏厚度、腹水、胃左静脉内径、门静脉内径、食管静脉曲张、RDW、miR-130a均为乙肝肝硬化并发GB病情影响因素(P<0.05)。结论RDW、miR-130a与乙肝肝硬化并发GB患者肝功能存在良好线性关系,也是乙肝肝硬化并发GB病情的重要影响因素,二者联合检测可为临床诊断乙肝肝硬化并发GB、评估病情程度、开展个性化治疗提供一种新途径。Objective To investigate the relationship between red blood cell distribution width(RDW),microRNA-130a(miR-130a)and hepatitis B liver cirrhosis with gastrointestinal bleeding(GB)and disease progression.Methods From January 2017 to September 2020,a total of 204 patients with hepatitis B liver cirrhosis complicated with GB were selected in the hospital,and they were divided into GB group(n=71)and non-GB group(n=133)according to the presence or absence of GB.The levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT),γ-glutamyl transpeptidase(GGT),RDW,and miR-130a expression were compared between the two groups.The correlation between RDW,miR-130a and liver function indexes and the diagnostic efficacy of hepatitis B liver cirrhosis complicated with GB were analyzed.At the same time,the clinical data,liver function indexes,RDW,and miR-130a expression of patients with different disease levels in the GS group were compared,and the influencing factors of the degree of hepatitis B liver cirrhosis complicated with GB disease were explored.Results The levels of AST,ALT,GGT and RDW in the GB group were higher than those in the non-GB group,and miR-130a was lower than the non-GB group,and the differences were statistically significant(P<0.05).RDW of GB patients was positively correlated with AST,ALT,GGT,and the expression of miR-130a was negatively correlated with AST,ALT,GGT(P<0.05).Receiver operating characteristic(ROC)curve showed that the AUC of combined detection of RDW and miR-130a expression in the diagnosis of hepatitis B cirrhosis complicated by GB was the largest,which was 0.771,and the sensitivity and the specificity were 77.46%and 68.42%,respectively.Child-Pugh classification,spleen thickness,ascites,left gastric vein inner diameter,portal vein inner diameter,esophageal varices,RDW,miR-130a were all influencing factors of the condition of hepatitis B liver cirrhosis complicated by GB(P<0.05).Conclusion There is a good linear relationship between RDW,miR-130a and liver function in patients with he

关 键 词：红细胞分布宽度 微小RNA-130a 乙型肝炎肝硬化 消化道出血 病情进展 

分 类 号：R575.2[医药卫生—消化系统] R512.62[医药卫生—内科学]