血清锌浓度与肝硬化失代偿肝功能损伤程度的关联及对预后的预测效能  

Correlation between serum zinc concentration and the degree of decompensated liver function damage in liver cirrhosis and its predictive efficacy for short-term prognosis

作　　者：钱盈 张笑涵 Qian Ying;Zhang Xiaohan(Department of Biochemistry,Nanyang Central Hospital,Nanyang,Henan473000,China)

机构地区：[1]河南省南阳市中心医院生化室,河南南阳473000

出　　处：《实用医技杂志》2023年第5期305-309,共5页Journal of Practical Medical Techniques

基　　金：河南省医学科技攻关项目(LHGJ20210022120)。

摘　　要：目的分析血清锌浓度(Zn)与肝硬化失代偿肝功能损伤程度的相关性及对短期预后的预测效能。方法回顾性收集2021年1月至2023年3月河南省南阳市中心医院收治的126例肝硬化失代偿患者。根据Child-pugh肝功能分级将A级、肝功能轻度损伤的36例患者分为轻度组,将B级、肝功能中度损伤的45例患者分为中度组,将C级、肝功能重度损伤的45例患者分为重度组,比较3组患者的血清Zn浓度及肝功能指标间的差异,经Spearman相关分析Zn与肝功能指标的相关性;统计入组患者180 d内不良预后发生情况,将预后良好的患者列为A组,预后不良的患者列为B组,比较2组Zn水平及生存情况,通过绘制受试者工作特征(ROC)曲线及曲线下面积(AUC)分析Zn对肝硬化失代偿短期预后的预测效能。结果轻度组患者的Zn(1.38±0.46)mg/L,均高于中度组、重度组[(0.77±0.26)mg/L、(0.34±0.18)mg/L],谷草转氨酶(AST)(70±11)U/L,谷丙转氨酶(ALT)(71±10)U/L,血清总胆红素(TBIL)(60±10)μmol/L,均低于中度组[(77±10)U/L、(77±10)U/L、(66±10)μmol/L]、重度组[(83±10)U/L、(83±10)U/L、(73±10)μmol/L],差异具有统计学意义(P<0.05)。经Spearman相关分析,Zn与AST、ALT、TBIL呈负相关。126例患者中短期不良预后发生率为49.2%(62/126),A组患者的Zn水平为(0.82±0.25)mg/L,高于B组(0.41±0.17)mg/L,差异具有统计学意义(P<0.05)。Zn水平对肝硬化失代偿短期不良预后的预测敏感度为88.45%、特异度为85.25%,截断值为0.5 mg/L,若血清Zn<0.5 mg/L,肝硬化失代偿患者发生不良预后的风险更高。结论血清Zn表达与肝硬化失代偿肝功能损伤程度负相关,Zn水平越低,患者不良预后的发生率越高。Objective To analyze the correlation between serum Zn and the degree of decompensated liver function damage in liver cirrhosis and its predictive efficacy for short-term prognosis.Methods This article is a retrospective study,with cases included from January 2021 to March 2023.The study subjects were 126 decompensated patients with liver cirrhosis in Nanyang Central Hospital.According to the Child-pugh liver function grading,thirty-six patients with Child-pugh grading of A grade and mild liver function injury were classified as mild groups,forty-five patients with(Child-pugh grading of)B grade and moderate liver function injury were classified as moderate groups,and 45 patients with(Child-pugh grading of)C grade and severe liver function injury were classified as severe groups.The differences in serum Zn concentration and liver function index levels among the three groups of patients were compared,and the correlation(between Zn levels and liver function indicators)was verified by Spearman correlation coefficient.The occurrence of adverse prognosis was counted in enrolled patients within 180 days,and then classified patients without adverse prognosis as Group A,patients with adverse prognosis as Group B.The differences of Zn levels and survival situations between the two groups were compared,and the predictive efficacy of Zn on the prognosis of decompensated liver cirrhosis was verified by the ROC and AUC.Results The Zn level of patients in the mild group was(1.38±0.46)mg/L,higher than those in the moderate and severe groups[(0.77±0.26)mg/L,(0.34±0.18)mg/L].AST level was(70±11)U/L,ALT level was(71±10)U/L,and TBIL level was(60±10)μmol/L,the indicators of which were all lower than those in the moderate group[(77±10)U/L,(77±10)U/L,(66±10)μmol/L],and in the severe group[(83±10)U/L,(83±10)U/L,(73±10)μmol/L](P<0.05).According to Spearman correlation coefficient test,Zn level was negatively correlated with AST,ALT,and TBIL levels.According to statistics,the incidence of short-term adverse prognosis in 126

关 键 词：肝硬化 肝疾病 锌 数据相关性 

分 类 号：R575.2[医药卫生—消化系统]