血清蛋氨酸对药物性肝损伤程度的预测分析  

Predictive Analysis of Serum Methionine Level on the Severity of Drug-induced Liver Injury

作　　者：赵婷婷 朱金朋 韩遵文 田蕾 Zhao Tingting;Zhu Jinpeng;Han Zunwen;Tian Lei(Department of Gastroenterology,the First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000 China)

机构地区：[1]锦州医科大学附属第一医院消化内科,辽宁锦州121000

出　　处：《锦州医科大学学报》2022年第1期55-60,共6页Journal of Jinzhou Medical University

基　　金：辽宁省科学技术基金项目,项目编号:2020-MS-295。

摘　　要：目的分析血清蛋氨酸水平在预测药物性肝损伤严重程度中的临床价值。方法选取211例实验对象,其中选取我院124例药物性肝损伤患者作为实验组,根据其肝损伤的严重程度分为轻、中、重度3组,其中轻组43人,中组46人,重组35人;另外选择87例健康体检者作为正常对照组;对比上述4组的谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、总胆红素(TBIL)及蛋氨酸(MET)水平,以此进行分析。结果治疗前轻、中、重度3组药物性肝损伤患者的ALT、AST、ALP、TBIL及MET均高于正常对照组;随着肝损伤程度加重,血清MET水平逐渐升高,各组间两两比较差异均有统计学意义(P<0.05);MET诊断药物性肝损伤的AUC、敏感度、特异度为0.911,86%,98%;经Pearson相关性分析发现,治疗前药物性肝损伤患者的MET与ALT、AST、ALP、TBIL均呈正相关(P<0.05)。治疗3 d后,轻、中、重度肝损伤组的MET水平低于治疗前,差异有统计学意义(P<0.05)。经治疗2 w后,治疗有效者的MET指标低于治疗无效者,差异具有统计学意义(P<0.05)。结论血清蛋氨酸水平可作为药物性肝损伤的辅助诊断指标,且可作为预测药物性肝损伤严重程度及预后的指标。Objective To analyze the clinical value of serum methionine level in predicting the severity of drug-induced liver injury.Methods 211 experimental subjects were selected,of which 124 patients with drug-induced liver injury in our hospital were selected as the experimental group.According to the severity of liver injury,they were divided into mild,moderate and severe groups,including 43 cases in the mild group,46 in the medium group and 35 in the severe group.In addition,87 healthy subjects were selected as the normal control group.The levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),total bilirubin(TBIL)and methionine(MET)in the above four groups were compared for analysis.Results Before treatment,ALT,AST,ALP,TBIL and MET of patients with drug-induced liver injury in mild,moderate and severe groups were higher than those in normal control group.With the aggravation of liver injury,the level of serum MET increased gradually,with significant difference(P<0.05).The AUC,sensitivity and specificity of MET in the diagnosis of drug-induced liver injury were 0.911,86%and 98%,and Pearson correlation analysis showed that MET was positively correlated with ALT,AST,ALP and TBIL in patients with drug-induced liver injury before treatment(P<0.05).After 3 days of treatment,MET levels in mild,moderate and severe groups were significantly lower than those before treatment(P<0.05).After 2 weeks of treatment,MET indexes of patients with treatment effect were lower than those of patients who did not respond to treatment without and the difference was statistically significant(P<0.05).Conclusion Serum methionine level can be used as an auxiliary diagnostic index of drug-induced liver injury,and can be used as an index to predict the severity and prognosis of drug-induced liver injury.

关 键 词：蛋氨酸 药物性肝损伤 谷丙转氨酶 谷草转氨酶 

分 类 号：R969.4[医药卫生—药理学]