CER、SAA在急性肝衰竭患者血清中的表达及其预后相关性分析  

The expression of CER and SAA in the serum of patients with acute liver failure and their prognostic correlation analysis

作　　者：耿艳[1] 李岩 胡柏生 GENG Yan;LI Yan;HU Bai-sheng(Department of Emergency,Baoshan Branch of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine(Shanghai,201900)China)

机构地区：[1]上海中医药大学附属曙光医院宝山分院急诊科,上海201900

出　　处：《中西医结合肝病杂志》2023年第2期138-141,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：上海市卫生健康委员会科研项目(No.20214Y0233)。

摘　　要：目的:检测铜蓝蛋白(CER)和血清淀粉样蛋白A(SAA)在急性肝衰竭(ALF)患者血清中的表达水平,并探讨两者表达在ALF患者预后中的影响。方法:2017年4月至2020年4月收治的101例ALF患者(ALF组)和同期体检的健康者(对照组)作为研究对象,采用免疫散射比浊法和酶联免疫吸附试验(ELISA)检测各组受试者血清中CER、SAA的表达水平,通过Pearson法分析CER和SAA表达水平与终末期肝病模型(MELD)评分之间的相关性,ROC曲线计算CER、SAA和MELD评分预测ALF患者3个月预后的曲线下面积(AUC)及95%置信区间(95%CI)。结果:与对照组相比,ALF组患者血清中CER水平明显降低,SAA水平明显升高,ALF患者血清中的CER水平与MELD评分呈负相关,SAA水平与MELD评分呈正相关;血清CER和SAA的AUC分别为0.784(95%CI 0.695~0.872)、0.770(0.679~0.862),敏感度分别为69.0%、81.0%,特异性分别为78.0%、67.8%;MELD评分AUC为0.767(95%CI 0.671~0.864),敏感度为52.4%,特异性为93.2%;血清CER和SAA水平的AUC均与MELD评分的AUC之间无差异。结论:CER和SAA的表达水平在ALF的病理过程中具有重要作用。同时,ALF患者中两者的表达水平与MELD评分具有相似的预后评估价值,可作为ALF患者预后评估的指标。Objective:To study the expression levels of ceruloplasmin(CER)and serum amyloid A(SAA)in the serum of patients with acute liver failure(ALF),as well as the relationship between CER,SAA and the prognosis of ALF patients.Methods:From April 2017 to April 2020,101 patients with ALF and healthy people who underwent physical examination during the same period were enrolled in this study.The immunoscattering turbidimetric method and enzyme-linked immunosorbent assay(ELISA)were used to detect the expression levels of CER and SAA in the serum of patients in each group.Pearson’s patterns was used to analyze the correlation between the expression levels of CER and SAA and the end-stage liver disease(MELD)score.ROC curve was used to calculate the area under the curve(AUC)and 95%confidence interval(95%CI)of CER,SAA and MELD scores for the prognosis of ALF patients.Results:The CER level in the serum of the ALF group was significantly decreased,and the SAA level was significantly increased which was statistically significant in comparison with the control group.The CER level in the serum of ALF patients was negatively correlated with the MELD score,while SAA level had a positive relation with the MELD score.The AUC of serum CER and SAA were 0.784(95%CI:0.695~0.872)and 0.770(0.679~0.862)the sensitivity were 69%and 81%,and the specificity were 78%and 67.8%.The AUC of MELD score was 0.767(95%CI:0.671~0.864),the sensitivity was 52.4%,and the specificity was 93.2%.There was no difference between the AUC of serum CER and SAA levels and the AUC of MELD score.Conclusion:The expression levels of CER and SAA play an important role in the pathological process of ALF.At the same time,the expression levels of the two in ALF patients have similar prognostic evaluation value with MELD score,which can be used as indicators for prognostic evaluation of ALF patients.

关 键 词：急性肝衰竭 铜蓝蛋白 血清淀粉样蛋白A 预后 

分 类 号：R575.3[医药卫生—消化系统]