NOD样受体家族蛋白3炎症小体对肝硬化轻微型肝性脑病的影响及诊断价值分析  

The influence and diagnostic value of NOD-like receptor family protein-3 inflammatosomes on mild and microhepatic encephalopathy in cirrhosis

作　　者：崔兴华 杨毅 孙婷 董俊飞 CUI Xinghua;YANG Yi;SUN Ting;DONG Junfei(Department of Infection,Northern Theater General Hospital,Shenyang,Liaoning,110000,China)

机构地区：[1]北部战区总医院感染科,辽宁沈阳110000

出　　处：《当代医学》2023年第25期91-95,共5页Contemporary Medicine

摘　　要：目的探讨NOD样受体家族蛋白3(NLRP3)炎症小体对肝硬化轻微型肝性脑病的影响及诊断价值。方法回顾性分析2020年2月至2021年8月北部战区总医院感染科确诊的145例乙型肝炎肝硬化患者的临床资料,采用单因素和多因素Logistics回归分析肝硬化轻微型肝性脑病的影响因素,绘制ROC曲线分析血浆NLRP3炎症小体对肝硬化轻微型肝性脑病的诊断价值。结果145例乙型肝炎肝硬化患者中,轻微型肝性脑病肝硬化患者62例,非轻微型肝性脑病肝硬化患者83例。轻微型肝性脑病肝硬化患者与非轻微型肝性脑病肝硬化患者年龄、性别、肝硬化病程及天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)水平比较差异无统计学意义;轻微型肝性脑病肝硬化患者外周血总胆红素(TBil)、血氨水平与数字连接实验-A、数字连接实验-B、数字符号实验、轨迹描绘实验、系列打点实验评分及血清白细胞介素6(IL-6)、NLRP3炎症小体水平均高于非轻微型肝性脑病肝硬化患者,差异有统计学意义(P<0.05)。Logistics回归分析结果显示,TBil、血氨、IL-6及NLRP3炎症小体是肝硬化患者发生轻微型肝性脑病的影响因素(P<0.05)。ROC曲线分析结果显示,血清NLRP3炎症小体诊断肝硬化轻微型肝性脑病的AUC为0.76,Cut-off值为52.35 ng/L,灵敏度为62.46%,特异度为95.00%。结论血清NLRP3炎症小体与乙型肝炎肝硬化轻微型肝性脑病关系密切,对该病诊断具有参考价值。Objective To investigate the effect of NOD-like receptor family protein 3(NLRP3)inflammatory bodies on mild and microhepatic encephalopathy in liver cirrhosis and its diagnostic value.Methods The clinical data of 145 patients with hepatitis B cirrhosis diagnosed in the de-partment of Infection of the Northern Theater General Hospital from February 2020 to August 2021 were retrospectively analyzed,Univariate and multivariate Logistic regression analysis were used to analyze the influencing factors of mild and microhepatic encephalopathy in cirrhosis,ROC curve was drawn to analyze the diagnostic value of plasma NLRP3 inflammasome in cirrhotic microhepatic encephalopathy.Results A total of the 145 patients with hepatitis b cirrhosis,62 had mild microhepatic encephalopathy and 83 had non-mild microhepatic encephalopathy.There were no significant differences in age,sex,course of cirrhosis and the levels of aspartate aminotransferase(AST)and alanine aminotransferase(ALT)be-tween patients with mild and microhepatic encephalopathy and those without microhepatic encephalopathy;the total bilirubin(TBil),blood ammonia levels and the scores of digital connection test-A,digital connection test-B,number symbol test,locus mapping test,series dot test,levels of serum in-terleukin6(IL-6)and NLRP3 inflammatome in the patients with mild and microhepatic encephalopathy cirrhosis were higher than those in the pa-tients with non-mild and microhepatic encephalopathy cirrhosis,and the differences were statistically significant(P<0.05).The results of Logistics regression analysis showed that TBil,blood ammonia,IL-6 and NLRP3 inflammasome were the influential factors for the occurrence of microhepatic encephalopathy in patients with cirrhosis(P<0.05).ROC curve analysis showed that the AUC of serum NLRP3 inflammatosomes in the diagnosis of mild and microhepatic encephalopathy was 0.76,the Cut-off value was 52.35 ng/L,the sensitivity was 62.46%,and the specificity was 95.00%.Conclusion The serum NLRP3 inflammatome is closely related to the

关 键 词：NOD样受体家族蛋白3 肝硬化 轻微型肝性脑病 肝性脑病心理测试评分 

分 类 号：R575.2[医药卫生—消化系统] R74[医药卫生—内科学]