血清M30及M65对药物性肝损伤患者肝脏炎症的诊断价值  

Diagnostic value of serum M30 and M65 for liver inflammation in patients with drug-induced liver injury

作　　者：阚延婷 吴卫锋 杨永峰 KAN Yan-ting;WU Wei-feng;YANG Yong-feng(Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine,Nanjing Second Hospital,Jiangsu 210003,China)

机构地区：[1]南京中医药大学附属南京医院,南京市第二医院肝病科,210003

出　　处：《肝脏》2022年第10期1116-1119,共4页Chinese Hepatology

摘　　要：目的明确血清M30及M65对药物性肝损伤患者肝脏炎症的诊断价值。方法选择2020年6月—2021年6月南京市第二医院肝病一科收治的39例药物性肝损伤患者,根据入院时肝脏炎症程度分为轻-中度组24例和重度组15例,并选取18例健康体检者作为对照组。采用酶联免疫吸附法(ELISA)检测药物性肝损伤患者及健康对照者血清M30及M65水平的差异,以及药物性肝损伤患者治疗前后的血清M30及M65水平变化,分析血清M30及M65水平与肝功能指标的相关性。结果轻-中度组及重度组的血清M30分别为(256.41±50.61)U/L、(1116.69±136.83)U/L,M65分别为(1007.98±291.15)U/L、(3963.68±614.62)U/L,均高于健康对照组(47.53±5.69)U/L和(64.74±5.25)U/L(P<0.05);重度组的血清M30、M65均高于轻-中度组(P<0.05);经过治疗肝脏炎症恢复后检测的M30与健康对照组比较无统计学差异(P>0.05),M65仍高于健康对照组,差异有统计学意义(P<0.05);M65与ALT(r=0.523,P<0.05)、AST(r=0.512,P<0.05)、γ-GT(r=0.434,P<0.05)及ALP(r=0.423,P<0.05)成正相关;M30与ALT(r=0.748,P<0.05)、AST(r=0.525,P<0.05)成正相关,而与γ-GT(r=0.325,P>0.05)及ALP(r=0.415,P>0.05)虽成正相关,但差异无统计学意义。结论血清M30、M65水平是反映药物性肝损伤患者肝细胞坏死和凋亡较灵敏的指标,与肝脏炎症相关,有一定的临床辅助价值。Objective To determine the diagnostic value of serum M30 and M65 for liver inflammation in patients with drug-induced liver injury(DILI).Methods From June 2020 to June 2021,37 patients with drug-induced liver injury were selected from the First Department of Hepatology,Nanjing Second Hospital.According to the degree of liver inflammation at admission,they were divided into mild-moderate group(24 cases)and severe group(15 cases),and 18 healthy people were selected as control group.Enzyme-linked immunosorbent assay was used to detect the difference of serum M30 and M65 levels between DILI patients and healthy controls,and the changes of serum M30 and M65 levels before and after treatment.Analyzing the correlation between serum M30 and M65 levels and liver function indexes,including alaninetransaminase(ALT),aspartatetransaminase(AST),gamma-glutamyl transferase(γ-GT),alkaline phosphatase(ALP).Results Serum M30 in mild-moderate group and severe group were(256.41±50.61)U/L and(1116.69±136.83)U/L respectively,and serum M65 in mild-moderate group and severe group were(1007.98±291.15)U/L and(3963.68±614.62)U/L respectively,both were higher than healthy control group(P<0.05).After treatment,there was no significant difference between M30 detected after liver inflammation recovery and healthy control group(P>0.05),but M65 was still higher than that of healthy control group(P<0.05).M65 was positively correlated with ALT(r=0.523,P<0.05),AST(r=0.512,P<0.05),γ-GT(r=0.434,P<0.05)and ALP(r=0.423,P<0.05).M30 was positively correlated with ALT(r=0.748,P<0.05)and AST(r=0.525,P<0.05).There is a positive correlation withγ-GT(r=0.325,P>0.05)and ALP(r=0.415,P>0.05),but there is no statistical difference.Conclusion Serum M30 and M65 levels are sensitive indicators to reflect hepatocyte necrosis and apoptosis in patients with DILI,which are related to liver inflammation and have certain clinical auxiliary value.

关 键 词：药物性肝损伤 M30 M65 

分 类 号：R575[医药卫生—消化系统]