八种血清学指标判断肝纤维化的对比研究  

Comparison of eight serological indexes in judging liver fibrosis

作　　者：谭小瑞 田文广[2] 万克强[2] Tan Xiaorui;Tian Wenguang;Wan Keqiang(Physical Examination Center,Yongchuan Hospital Affiliated to Chongqing Medical University,Chongqing 402160;Department of Infectious Diseases,Yongchuan Hospital Affiliated to Chongqing Medical University,Chongqing 402160)

机构地区：[1]重庆医科大学附属永川医院体检中心,重庆402160 [2]重庆医科大学附属永川医院感染科,重庆402160

出　　处：《中国社区医师》2021年第31期115-116,共2页Chinese Community Doctors

基　　金：重庆市永川区自然科学基金研究项目(2016nc5021)。

摘　　要：目的:探讨八种无创性血清学指标判断肝纤维化的价值。方法:2020年1-9月收治慢性乙型病毒性肝炎患者38例,患者均进行肝穿刺活检,根据肝纤维化程度不同分为肝纤维化2级及以上(≥S2)组22例、肝纤维化1级及以下(≤S1)组16例。检测所有患者血清羟基凝血酶原(DCP)、骨桥蛋白(OPN)、血小板生长衍生因子BB(PDGF-BB)和基质金属蛋白酶抑制剂-1(TIMP-1)四个血清学指标水平;同时检测传统肝纤谱四项:透明质酸酶(HA)、层黏蛋白(LN)、Ⅲ型前胶原肽(PⅢP)和IV型胶原(CIV)水平。观察八种血清学指标水平与肝纤维化的关系。结果:≥S2组的DCP、OPN、PDGF-BB和TIMP-1水平均高于≤S1组,差异有统计学意义(P=0.00)。八个血清学指标判断肝纤维化≥S2的AUCs,由高到低分别为CIV(0.93)、 HA(0.91)、 PⅢP(0.89)、 OPN(0.88)、 DCP(0.87)、 TIMP-1(0.86)、 LN(0.85)、PDGF-BB(0.85)。结论:DCP、OPN、PDGF-BB和TIMP-1四个血清学指标水平随着肝纤维化的发展,均呈增加趋势。OPN、HA、PⅢP、CIV为判断肝纤维化的敏感指标,具有较高诊断价值。Objective:To explore the value of eight non-invasive serological indexes in judging liver fibrosis.Methods:From January to September 2020,38 patients with chronic viral hepatitis B were selected.All patients underwent liver biopsy.According to the degree of liver fibrosis,they were divided into the liver fibrosis grade 2 and above(≥S2)group with 22 patients,the liver fibrosis grade 1 and below(≤S1)group with 16 patients.We detected the four serum levels of serum hydroxyl prothrombin(DCP),osteopontin(OPN),platelet growth-derived factor BB(PDGF-BB)and matrix metalloproteinase inhibitor-1(TIMP-1)in all patients.Simultaneously detection of four traditional liver fiber spectrum:hyaluronidase(HA),laminin(LN),type Ⅲ procollagen peptide(PⅢP)and type IV collagen(CIV)levels.We observed the relationship between the levels of eight serum indexes and liver fibrosis.Results:The levels of DCP,OPN,PDGF-BB and TIMP-1 in the≥S2 group were higher than those in the≤S1 group,the difference was statistically significant(P=0.00).Eight serological indicators to determine the AUCs of liver fibrosis≥S2,from high to low were CIV(0.93),HA(0.91),PⅢP(0.89),OPN(0.88),DCP(0.87),TIMP-1(0.86),LN(0.85),PDGF-BB(0.85).Conclusion:DCP,OPN,PDGF-BB and TIMP-1 four serum index levels all show an increasing trend with the development of liver fibrosis.OPN,HA,PⅢP,and CIV are sensitive indicators for judging liver fibrosis and have high diagnostic value.

关 键 词：血清学指标 肝纤维化 对比 

分 类 号：R575.2[医药卫生—消化系统]