血清人连蛋白在肝硬化患者中的表达及其与肝硬化分级的关联性  

Expression level of zonulin in liver cirrhosis and its value in grading liver cirrhosis

作　　者：陈洲 郭力硕 冉辰辰 赵昌翔 CHEN Zhou;GUO Lishuo;RAN Chenchen;ZHAO Changxiang(Department of General Surgury,Chongqing Armed Police Corps Hospital,Chongqing 400000,China)

机构地区：[1]中国人民武装警察部队重庆市总队医院普外科,重庆400000

出　　处：《淮海医药》2022年第3期230-233,共4页Journal of Huaihai Medicine

摘　　要：目的:探讨肝硬化患者血清人连蛋白(Zonulin)表达水平与肝硬化分级的关系。方法:选取某院肝病科收治的164例肝硬化患者作为肝硬化组,选取同期体检中心体检的健康受试者80例作为对照组,根据Child-Pugh分级将肝硬化组患者分为A级(55例)、B级(60例)、C级(49例)。根据CT形态分级将肝硬化组患者分为Ⅰ级(21例)、Ⅱ级(32例)、Ⅲ级(54例)、Ⅳ级(57例)。检测研究对象血清Zonulin、甲胎蛋白(AFP)、白蛋白(ALB)、总胆红素(TBIL)水平和凝血酶原时间(PT),分析血清Zonulin与AFP、ALB、TBIL、PT的相关性,评估血清Zonulin诊断肝硬化的价值。结果:肝硬化组患者AFP、TBIL和PT水平高于对照组,Zonulin和ALB水平低于对照组(P<0.05)。随着Child-Pugh分级增高,肝硬化患者血清Zonulin水平逐渐下降;随着CT形态分级增高,肝硬化患者血清Zonulin水平逐渐下降,差异均有统计学意义(P<0.05)。血清Zonulin水平与AFP、TBIL和PT呈负相关(r值分别为-0.401、-0.448、-0.523,P<0.05),与ALB呈正相关(r值为0.309,P<0.05)。血清Zonulin诊断肝硬化的ROC曲线下面积为0.782(95%CI:0.721~0.823),最佳截断值为38.69 ng/mL,约登指数为0.515,灵敏度和特异度分别为78.25%和73.21%。结论:肝硬化患者血清Zonulin水平降低,肝硬化严重程度不同的患者Zonulin水平表达也不同,对肝硬化的诊断和分级预测具有一定应用价值。Objective:To investigate the relationship between the expression level of serum zonulin and the grade of liver cirrhosis in patients with liver cirrhosis.Methods:164 patients with liver cirrhosis (cirrhosis group) and 80 healthy subjects (control group) were selected from a hospital. According to the Child-Pugh grades, the patients in the cirrhosis group were divided into grade A (55 cases), grade B (60 cases), and grade C (49 cases). According to the CT morphology grades, the patients in the cirrhosis group were divided into grade I (21 cases), grade II (32 cases), grade III (54 cases) and grade IV (57 cases). The levels of serum zonulin, alpha fetoprotein (AFP), albumin (ALB), total bilirubin (TBIL) and prothrombin time (PT) were detected in the two groups. The correlation between serum zonulin and the various biomarkers were analyzed, and the value of serum zonulin in the grading diagnosis of liver cirrhosis was explored.Results:The levels of AFP, TBIL and PT in the patients of cirrhosis group were higher than those in the control group, while the levels of zonulin and ALB were lower than those in the control group (P<0.05).As Child-Pugh grades increased, the serum zonulin levels in the patients gradually decreased.As the CT morphological grades increased, the serum zonulin levels in the patients gradually decreased.The differences were all significant (P<0.05).Serum zonulin levels were negatively correlated with AFP,TBIL and PT (r=-0.401,-0.448,-0.523 respectively,P<0.05), and positively correlated with ALB (r=0.309,P<0.05).The area under the ROC curve of serum zonulin for diagnosing liver cirrhosis was 0.782 (95% CI:0.721~0.823). When the cut-off value of zonulin was 38.69 ng/mL, the Youden index was the largest (0.515). The sensitivity and specificity of the diagnosis were 78.25% and 73.21% respectively.Conclusion:The serum zonulin level is lower in patients with cirrhosis, which is related to the severity of liver cirrhosis, and has a certain application value in the grading diagnosis and classification of

关 键 词：肝硬化 血清人连蛋白 诊断 分级 

分 类 号：R575.2[医药卫生—消化系统]