血清sP-selectin、sICAM-1水平变化在肝硬化患者中的临床意义  

Clinical Significance of Changes in Serum sP-selectin and sICAM-1 Levels in Patients with Liver Cirrhosis

作　　者：王伟伟 宋秋环 李凯 WANG Wei-wei;SONG Qiu-huan;LI Kai(Department of Gastroenterology,Xuchang Hospital,Xuchang,Henan,461000,China)

机构地区：[1]许昌医院消化内科,河南许昌461000

出　　处：《中国血液流变学杂志》2023年第2期218-221,共4页Chinese Journal of Hemorheology

摘　　要：目的分析血清可溶性P-选择素(sP-selectin)、可溶性细胞间黏附分子-1(sICAM-1)水平变化在肝硬化患者中的临床意义。方法选取2018年1月—2022年7月肝硬化患者94例作研究组,选取同期肝硬化所致肝癌患者51例作为对照组,对比两组以及不同Child-Pugh分级血清sP-selectin、sICAM-1水平,并分析血清水平和分级相关性、肝癌诊断效能。结果随Child-Pugh分级增加,血清sP-selectin、sICAM-1水平增加,即C级高于A级、B级,B级高于A级(P<0.05);经Pearson分析结果显示,血清sP-selectin水平(r=0.698)、血清sICAM-1水平(r=0.714)与肝硬化Child-Pugh分级呈正相关(P<0.05);研究组血清sP-selectin、sICAM-1水平低于对照组(P<0.05);以肝癌患者作为阳性样本,以肝硬化患者作为阴性样本,依据血清sP-selectin、sICAM-1水平变化趋势制为ROC曲线,结果为,联合诊断AUC为0.834、敏感性98.04%、特异性95.74%,sP-selectin的AUC为0.828、敏感性90.20%、特异性85.11%,sICAM-1的AUC为0.803、敏感性86.27%、特异性82.98%,其中联合诊断敏感性、特异性最高(P<0.05)。结论肝硬化患者随病情加重,血清sP-selectin、sICAM-1水平随之升高,且动态监测可早期诊断肝癌。Objective To analyze the clinical significance of serum levels of soluble P-selectin(sP-selectin)and soluble intercellular adhesion molecule-1(sICAM-1)in patients with cirrhosis.Methods 94 patients with liver cirrhosis from January 2018 to July 2022 were selected as the study group,and 51 patients with liver cancer caused by liver cirrhosis during the same period were selected as the control group.The serum sP-selectin and sICAM-1 levels of the two groups and different Child-Pugh grades were compared,and the correlation between serum levels and grades as well as the diagnostic efficacy of liver cancer were analyzed.Results With the increase of Child-Pugh grade,serum sP-selectin and sICAM-1 levels increased,that is,C grade was higher than A grade,B grade was higher than A grade(P<0.05).The results of Pearson analysis showed that serum sP-selectin level(r=0.698)and serum sICAM-1 level(r=0.714)were positively correlated with Child-Pugh grade of cirrhosis(P<0.05).The serum levels of sP-selectin and sICAM-1 in study group were lower than those in control group(P<0.05).The ROC curve was based on the serum sP-selectin and sICAM-1 levels in patients with liver cancer as positive samples and patients with cirrhosis as negative samples.The results showed that the AUC of combined diagnosis was 0.834,the sensitivity was 98.04%,and the specificity was 95.74%.The AUC of sP-selectin was 0.828,sensitivity 90.20%,specificity 85.11%,and that of sICAM-1 was 0.803,sensitivity 86.27%,specificity 82.98%,among which the combined diagnosis sensitivity and specificity were the highest(P<0.05).Conclusion The serum levels of sP-selectin and sICAM-1 in cirrhotic patients increase with the disease worsening,and dynamic monitoring can be used for early diagnosis of liver cancer.

关 键 词：可溶性P-选择素 可溶性细胞间黏附分子-1 肝硬化 CHILD-PUGH分级 肝癌 

分 类 号：R575.2[医药卫生—消化系统]