1b型慢性丙型肝炎患者血清巨噬细胞抑制因子-1水平升高临床价值分析  

Clinical value analysis of serum macrophage inhibitory factor-1 level in patients with chronic hepatitis C(CHC)genotype 1b

作　　者：宋洁 聂虹 迟卉 郭瑞芳 SONG Jie;NIE Hong;CHI Hui;GUO Rui-fang(Department of Gastroenterology,Inner Mongolia people′s Hospital,Hohhot 010010,China;Department of Gastroenterology,Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010010,China;Clinical Nutrition Center,Inner Mongolia People′s Hospital,Hohhot 010010,China)

机构地区：[1]内蒙古自治区人民医院消化内科,呼和浩特市010010 [2]内蒙古自治区人民医院临床营养中心,呼和浩特市010010 [3]内蒙古医科大学附属医院消化内科

出　　处：《肝脏》2023年第8期950-952,共3页Chinese Hepatology

基　　金：内蒙古自治区科技计划项目任务书(2020GG0085)。

摘　　要：目的探讨血清巨噬细胞抑制因子-1(MIC-1)水平对基因1b型慢性丙型肝炎(CHC)的影响。方法2016年1月至2019年3月收治的1b型CHC患者84例。以聚乙二醇干扰素+利巴韦林联合治疗,采用单因素、多因素分析比较不同病毒学应答结果1b型CHC患者资料。结果84例1b型CHC患者中病毒学应答61例,未应答组23例。应答组年龄为45(37,55)岁,高于未应答组的36(33,44)岁(P<0.05)。应答组ALT、AST、PⅢNP、C-Ⅳ及MIC-1为40(15,82)U/L、37(18,94)U/L、27.0(10.1,114.6)ng/mL、28.4(11.5,108.4)ng/mL及298.8(145.2,746.8)pg/mL,低于未应答组的56(26,122)U/L、49(22,120)U/L、33.7(11.3,160.6)ng/mL、36.7(14.1,170.1)ng/mL及646.3(156.7,1540.3)pg/mL(P<0.05)。84例1b型CHC患者治疗前MIC-1为714.8(171.0,1582.1)pg/mL,高于治疗后的365.0(159.9,1004.0)pg/mL(P<0.05);应答组治疗前MIC-1为720.4(184.7,1570.1)pg/mL,高于治疗后的298.8(145.2,746.8)pg/mL(P<0.05)。以1b型CHC患者病毒学应答状态为因变量,将年龄、ALT、AST、PⅢNP、C-Ⅳ及MIC-1进行多因素分析,得出MIC-1(HR=5.31,95%CI:2.74~11.52,P=0.008)为影响1b型CHC患者应答状态的独立危险因素。结论血清MIC-1是1b型CHC患者病毒学应答状态独立危险因素,可能是HCV感染的潜在诊断标志物。Objective To investigate the effect of macrophage inhibitory factor-1(MIC-1)level on chronic hepatitis C(CHC)genotype 1b by selecting appropriate cases.Methods A retrospective analysis of 84 patients with type 1b CHC from January 2016 to March 2019 was conducted,and the diagnosis of CHC was confirmed according to the standard scheme of CHC.All patients treated with pegylated interferon plus ribavirin,and different virological responses of patients were compared by univariate and multivariate analysis.Results Among the 84 patients with type 1b CHC,61 cases had virological responses while 23 cases did not.The age of the responding group[45(37,55)years]in this study was significantly higher than that of the non-responding group[36(33,44)years,P<0.05].The levels of ALT,AST,PⅢNP,CⅣand MIC-1 in the responding group were 40(15,82)U/L,37(18,94)U/L,27.0(10.1,114.6)ng/mL,28.4(11.5,108.4)ng/mL and 298.8(145.2,746.8)pg/mL,which were significantly lower than those in the non-responding group[56(26,122)U/L,49(22,120)U/L,33.7(11.3,160.6)ng/mL,36.7(14.1,170.1)ng/mL and 646.3(156.7,1540.3)pg/mL,P<0.05].The MIC-1[714.8(171.0,1582.1)pg/mL]of 84 patients with type 1b CHC before treatment was significantly higher than that after treatment[365.0(159.9,1004.0)pg/mL,P<0.05].The MIC-1 of the response group before treatment[720.4(184.7,570.1)pg/mL]was also significantly higher than that after treatment[298.8(145.2,746.8)pg/mL,P<0.05].However,there was no significant difference in the non-responding group before and after treatment[710.9(161.2,1532.7)pg/mL vs 646.3(156.7,1540.3)pg/mL,P>0.05].Taking the virological response status of patients with type 1b CHC as the dependent variable,multivariate Cox regression analysis was carried out on the data(age,ALT,AST,PⅢNP,C-Ⅳand MIC-1)which were different in single factor analysis.The results showed that MIC-1 was an independent risk factor[HR=5.31(95%CI:2.74~11.52),P=0.008],which affected type 1b CHC.Conclusion Serum MIC-1 level is an independent risk factor that affects the virological r

关 键 词：1b型慢性丙型肝炎 巨噬细胞抑制因子-1 病毒学应答 

分 类 号：R512.63[医药卫生—内科学]