乙肝肝纤维化患者血液miR-122、miR-181a水平与病情严重程度的关系  

Changes in miR-122 and miR-181a levels of patients with chronic hepatitis B and liver fibrosis and their relationship with the severity of liver fibrosis

作　　者：崔红梅[1] 卢坤玲[1] 付丽坤[1] 张利利[1] CUI Hongmei;LU Kunling;FU Likun;ZHANG Lili(Department of Gastroenterology,the First Hospital of Qinhuangdao,Qinhuangdao,Hebei,China,066000)

机构地区：[1]秦皇岛市第一医院消化内科,河北秦皇岛066000

出　　处：《分子诊断与治疗杂志》2021年第10期1693-1696,共4页Journal of Molecular Diagnostics and Therapy

基　　金：秦皇岛市科学技术局科技计划(201602A144)。

摘　　要：目的探讨慢性乙型肝炎(CHB)肝纤维化患者血液miR-122、miR-181a水平变化及与肝纤维化严重程度的关系。方法选择2018年3月至2020年5月本院收治的186例CHB患者作为CHB组,选取100例同期查体的健康体检者作为对照组。检测两组血液miR-122、miR-181a水平及肝脏生化指标,根据肝纤维化分期将CHB患者分为S0(25例)、S1(44例)、S2(35例)、S3(52例)、S4(30例),比较不同分期患者miR-122、miR-181a水平差异。结果CHB组天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)等生化指标及miR-122、miR-181a表达水平均显著高于对照组,差异均有统计学意义(P<0.05)。随着肝纤维化分期的升高,CHB患者ALT、AST、TBIL等肝生化指标及miR-181a表达升高,miR-122表达水平降低(P<0.05)。Pearson相关性分析显示,miR-122与CHB患者ALT、AST、TBIL等肝生化指标呈负相关(P<0.05),miR-181a与肝生化指标呈正相关(P<0.05)。Spearman相关性分析示,miR-122与肝纤维化程度呈负相关(P<0.05),miR-181a与肝纤维化程度呈正相关(P<0.05)。ROC曲线显示,miR-122、miR-181a表达水平诊断严重肝纤维化(S3~S4)的曲线下面积分别为0.851、0.783,当截点值为3.26、1.42时,约登指数最大。结论慢性乙肝肝纤维化患者伴有miR-122、miR-181a水平的变化,且与肝纤维化程度相关,临床可将血液miR-122、miR-181a作为评估纤维化程度的参考指标。Objective To explore the changes in miR-122 and miR-181a levels of patients with chronic hepatitis B(CHB)and liver fibrosis and their relationship with the severity of liver fibrosis.Methods A total of 186 patients with CHB(CHB group)and 100 healthy individuals(control group)were enrolled in this study from March 2018 to May 2020.The levels of miR-122,miR-181a and liver biochemical indicators in the two groups were measured.According to the grade of liver fibrosis,the patients were divided into S0(25 cases),S1(44 cases),S2(35 cases),S3(52 cases),and S4(30 cases).The levels of miR-122 and miR-181a in patients with different grades were compared.Results The expression levels of biochemical indicators[aspartate aminotransferase(AST),alanine aminotransferase(ALT),total bilirubin(TBIL)],miR-122 and miR-181a in the CHB group were significantly higher than those in the control group(P<0.05).With the increase of liver fibrosis grading,ALT,AST,TBIL and miR-181a were increased,while miR-122 was decreased in the CHB group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that miR-122 was negatively correlated with ALT,AST and TBIL(P<0.05),while miR-181a was positively correlated with the liver biochemical indicators(P<0.05).Spearman correlation analysis showedthat miR-122 was negatively correlated with the severity of liver fibrosis(P<0.05),while miR-181a was positively correlated with liver fibrosis(P<0.05).The ROC curve showed that the area under the curve(AUC)values of miR-122 and miR-181a for diagnosis of severe liver fibrosis(S3-S4)were 0.851 and 0.783,respectively.When the cut-off values were 3.26 and 1.42,the Youden index was the greatest.Conclusion There are changes in the levels of miR-122 and miR-181a in patients with CHB and liver fibrosis,which are related to the severity of liver fibrosis.Clinically,miR-122 and miR-181a can be used as reference indicators for evaluating the severity of liver fibrosis.

关 键 词：慢性乙型肝炎 肝纤维化 MIR-122 miR-181a 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]