血清中Ⅲ型胶原蛋白水平对HIV感染者肝纤维化及其肝功能障碍的预测价值  

Role of serum collagen typeⅢin predicting liver fibrosis and liver dysfunction in patients with HIV infection

作　　者：林兴明 王希会 Lin Xingming;Wang Xihui(Department of Laboratory,Linyi Central Hospital,Linyi 276400,China)

机构地区：[1]临沂市中心医院检验科,山东临沂276400 [2]临沂市中心医院输血科,山东临沂276400

出　　处：《海军医学杂志》2023年第10期1043-1046,共4页Journal of Navy Medicine

摘　　要：目的探究血清中Ⅲ型胶原蛋白(COLⅢ)对人类免疫缺陷病毒(HIV)感染者肝纤维化及其肝功能障碍的预测价值。方法选取2017年5月至2022年12月收治于临沂市中心医院的121例HIV感染者为研究对象。于患者初次就诊及6个月随访时进行肝穿刺活检。收集患者血清样本并检测COLⅢ及肝纤维化标志物Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(ⅣC)、透明质酸酶(HA)、层粘连蛋白(LN)的表达水平;检测患者丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、胆红素(SB)及前白蛋白(PA)的水平。通过受试者操作特征(ROC)曲线评价各检测指标预测肝纤维化及肝功能障碍的效能,并用多元Logistic回归法分析相关性。结果与肝纤维化S0期的HIV感染者相比,S1~S4期HIV感染者血清COLⅢ水平逐渐升高(P<0.05)。ROC曲线分析表明,COLⅢ对HIV感染者肝纤维化的预测效能高于常规肝纤维化标志物独立及联合预测效能;回归分析也表明,COLⅢ是HIV感染者肝纤维化的影响因素之一(P<0.05)。COLⅢ对HIV感染者肝功能障碍程度也具有良好的预测效能,且经回归分析表明,COLⅢ是HIV感染者肝功能障碍的影响因素之一(P<0.05)。结论血清中Ⅲ型胶原蛋白的水平能够有效预测HIV感染者肝纤维化及肝功能障碍程度,可作为此类患者发生肝纤维化及肝功能障碍的潜在生物学标志物,具有一定的临床应用价值。Objective To explore the predictive value of serum collagen typeⅢ(COLⅢ)for liver fibrosis and liver dysfunction in patients with human immunodeficiency virus(HIV)infection.Methods A total of 121 patients with HIV infection admitted to Linyi Central Hospital from May 2017 to December 2022 were enrolled in this study.Liver biopsy was performed at first treatment and 6 months after follow up.The serum samples of the patients were collected and COLⅢ,procollagenⅢ(PCⅢ),collagenⅣ(ⅣC),hyaluronic acid(HA)and laminin(LN)were detected.The levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum bilirubin(SB)and albumin(PA)were also detected.The predictive efficacy of each index on liver fibrosis and liver dysfunction was evaluated by receiver operating characteristic(ROC)curve,and the correlation was analyzed by multiple logistic regression.Results Compared with HIV infected patients in S0 stage of liver fibrosis,the level of serum COLⅢof HIV infected patients in S1‑S4 stages increased gradually(P<0.05).ROC curve analysis showed that COLⅢhad higher predictive efficiency than independent and combined prediction of routine hepatic fibrosis markers in HIV infected patients.Regression analysis also showed that COLⅢwas an influence factor of liver fibrosis in patients with HIV infection(P<0.05).COLⅢalso had a good predictive effect on liver dysfunction and was one of the influence factors of liver dysfunction in patients with HIV infection(P<0.05).Conclusion The serum level of COLⅢcan effectively predict liver fibrosis and liver dysfunction in patients with HIV infection.It can be used as a potential biomarker of liver fibrosis and liver dysfunction in clinical practice.

关 键 词：Ⅲ型胶原蛋白 HIV 肝纤维化 肝功能障碍 

分 类 号：R512.62[医药卫生—内科学] R512.91[医药卫生—临床医学]