γ-谷氨酰转肽酶与乙型肝炎患者肝组织纤维化的相关性分析  

Correlation between gamma-glutamyl transpeptidase and liver fibrosis in patients with hepatitis B

作　　者：马建 吴熙[1] 胡雪涛 徐珊珊 Ma Jian;Wu Xi;Hu Xuetao;Xu Shanshan(Fangshan Hospital,Beijing University of Chinese Medicine,Beijing 102400;Beijing Fangshan Hospital of Chinese Medicine,Beijing 102400)

机构地区：[1]北京中医药大学房山医院,北京102400 [2]北京房山中医医院,北京102400

出　　处：《基层医学论坛》2023年第34期95-97,共3页The Medical Forum

摘　　要：目的探讨γ-谷氨酰转肽酶(γ-glutamyl transpeptidase,γ-GT)与乙型肝炎患者肝组织纤维化的相关性。方法选择2020年5月—2021年12月期间北京中医药大学房山医院行肝病理组织活检确诊为慢性乙型肝炎(chronic hepatitis b,CHB)的124例患者作为研究对象,根据Metavir评分系统对患者肝组织纤维化程度进行分期并分组,分为S0期—S4期。采血后分别采用全自动生化分析仪检测血清γ-GT水平,化学发光法检测血清透明质酸(hyaluronic acid,HA)、层粘连蛋白(laminin,LN)、Ⅲ型前胶原(precollagen typeⅢ,PCⅢ)和Ⅳ型胶原(collage typeⅣ,Ⅳ-C)水平,分析CHB患者血清γ-GT水平与肝纤维化指标(HA、LN、PCⅢ、Ⅳ-C)的相关性。结果S1组—S4组γ-GT、HA、LN、PCⅢ、Ⅳ-C水平均高于S0组,差异有统计学意义(P<0.05)。S1组—S4组间γ-GT、HA、PCⅢ、Ⅳ-C水平两两比较差异有统计学意义(P<0.05),LN水平两两比较差异无统计学意义(P>0.05)。随着肝纤维化程度的提高,血清γ-GT、HA、PCⅢ、Ⅳ-C水平均有上升的趋势。经相关性分析后发现,CHB患者血清γ-GT与HA、PCⅢ、Ⅳ-C有正相关性(r>0,P<0.05),与LN无显著相关性(P>0.05)。ROC曲线分析结果表明,血清γ-GT诊断显著肝纤维化的曲线下面积为0.917(95%CI为0.859~0.974,P<0.001),灵敏度和特异度分别90.5%和90.0%。结论γ-GT与CHB患者肝组织纤维化指标HA、PCⅢ、Ⅳ-C具有相关性,可为CHB诊断及肝组织纤维化监测提供非创伤性的诊断依据。Objective To investigate the correlation between gamma-glutamyl transpeptidase(gamma-GT)and liver fibrosis in patients with hepatitis B.Methods A total of 124 patients diagnosed as chronic hepatitis B(CHB)by liver tissue biopsy in hospital from May 2020 to December 2021 were selected as research objects.The degree of liver fibrosis of patients was graded according to Metavir scoring system and divided into S0-S4.After blood collection,serum gamma-GT level was detected by automatic biochemical analyzer,and serum hyaluronic acid(HA),laminin(LN),typeⅢprocollagen(PCⅢ)and typeⅣcollagen(IV-C)levels were detected by chemiluminescence method.The correlation between serum gamma-GT level and hepatic fibrosis indexes(HA,LN,PCⅢ,IV-C)in CHB patients was analyzed.Results The levels ofγ-GT,HA,LN,PCⅢandⅣ-C in S1~S4 groups were higher than those in S0 group,and the difference was statistically significant(P<0.05).Pairwise comparison ofγ-GT,HA,PCⅢandⅣ-C levels among S1-S4 groups had statistical significance(P<0.05),while pairwise comparison of LN level had no statistical significance(P>0.05).The serum levels ofγ-GT,HA,PCⅢandⅣ-C increased with the increase of hepatic fibrosis degree.After correlation analysis,serum gamma-GT in CHB patients was positively correlated with HA,PCⅢandⅣ-C(r>0,P<0.05),but had no significant correlation with LN(P>0.05).ROC curve analysis showed that the area under the curve of serum gamma-GT was 0.917(95%confidence interval=0.859-0.974,P<0.001),and the sensitivity and specificity were 90.5%and 90.0%,respectively.Conclusion Gamma-GT is correlated with HA,PCⅢ,Ⅳ-C of hepatic fibrosis in patients with CHB,which can provide non-traumatic diagnostic basis for the diagnosis of CHB and hepatic fibrosis monitoring.

关 键 词：Γ-谷氨酰转肽酶 乙型肝炎 肝纤维化 

分 类 号：R575.1[医药卫生—消化系统]