血清β-arrestin 2、HIF-1a及CA125联合预测慢性乙型肝炎肝纤维化的价值  

The value of a combination of serumβ-arrestin 2,HIF-1αand CA125 to predict hepatic fibrosis in chronic hepatitis B patients

作　　者：汪蕾 陈晨 华喜梅 胡丰芬 WANG Lei;CHEN Chen;HUA Xi-mei;HU Feng-fen(Department of Medical Laboratory,Suqian First People′s Hospital,Jiangsu 223800,China;General Surgery Hepatobiliary Department,Suqian First People′s Hospital,Jiangsu 223800,China;Laboratory of Shuyang County Center for Disease Control and Prevention,Jiangsu223600,China;Department of Medical Laboratory,Shuyang County Traditional Chinese Medicine Hospital,Jiangsu 223800,China)

机构地区：[1]宿迁市第一人民医院医学检验科,江苏223800 [2]宿迁市第一人民医院普外肝胆,江苏223800 [3]宿迁市沭阳县疾控中心检验科,223600 [4]宿迁市沭阳县中医院医学检验科,223800

出　　处：《肝脏》2024年第5期521-525,共5页Chinese Hepatology

基　　金：江苏省科技厅社会发展重点项目(BE2019638)。

摘　　要：目的探讨血清β-抑制蛋白2(β-arrestin2)、缺氧诱导因子1a(hypoxia inducible factor1α,HIF-1a)及糖类抗原125(carbohydrate antigen 125,CA125)联合预测慢性乙型肝炎(chronic Hepatitis B,CHB)肝纤维化的价值。方法选择宿迁市第一人民医院于2019年5月—2022年5月收治的110例CHB患者为研究对象,设为观察组,另选同期于我院体检中心体检的110名健康者为对照组。比较两组血清β-arrestin2、HIF-1a、CA125水平、观察肝纤维化不同病理分期患者以上指标水平,另通过ROC明确以上指标联合预测CHB处于S4的价值,采用多因素logistic回归分析CHB处于S4的危险因素,采用Pearson相关性分析以上指标与肝硬化病理分期的相关性。结果与对照组相比,观察组血清β-arrestin2、HIF-1a、CA125水平均有显著升高(t=21.376、21.548、71.752,P<0.05);肝纤维化S1、S2、S3、S4患者的血清β-arrestin2、HIF-1a、CA125水平逐渐升高(F=140.309、63.837、82.963,P<0.05);经ROC分析证实血清β-arrestin2、HIF-1a、CA125水平均可用于CHB处于S4的预测中,曲线下面积分别为0.984、0.926、0.956,且联合诊断能够获得更高的曲线下面积0.999,均有P<0.05;多因素logistic回归分析显示,β-arrestin2≥96.37 pg/mL(OR=2.011,95%CI:1.211~3.339)、HIF-1a≥74.345μg/L(OR=1.696,95%CI:1.026~2.804)、CA125≥173.27 U/mL(OR=2.117,95%CI:1.974~3.987)是CHB处于S4的危险因素;血清β-arrestin2、HIF-1a、CA125水平与CHB肝纤维化分期呈正相关(r=0.458、0.651、0.531,均有P<0.05)。结论血清β-arrestin2、HIF-1a、CA125水平均能用于预测CHB肝纤维化,当以上指标水平越高肝纤维化程度越重,且联合应用时的敏感度更高,多个参数联合诊断可进一步提高诊断结果的客观性以及准确率,减少漏诊、误诊情况的发生,值得临床推广。Objective To investigate the value of serumβ-inhibitory protein 2(β-arrestin 2),hypoxia-inducing factor 1α(HIF-1α)and carbohydrate antigen 125(CA125)in the prediction of hepatic fibrosis in chronic hepatitis B(CHB)patients.Methods One hundred and ten CHB patients admitted from May 2019 to May 2022 were selected as the study subjects,and were set as the observation group.Another 110 healthy people who were examined in the physical examination center at the same period of time were selected as the control group.The serumβ-arrestin 2,HIF-1α,CA125 were compared between the two groups of people,and the above indicators in patients with different pathological stages of liver fibrosis were observed.Receiver operating characteristic curve(ROC)analysis was used to determine the value of the above indexes in predicting liver fibrosis stage 4(S4)in CHB patients.,Multiple logistic regression analysis was used to identify the risk factors of S4 CHB,Pearson correlation analysis was used to analyze the correlation between the above indexes and the pathological stage of cirrhosis.Results Compared with the control group,serumβ-arrestin2,HIF-1αand CA125 levels in observation group were significantly increased(t=21.376,21.548,71.752,P<0.05).The serumβ-arrestin2,HIF-1αand CA125 levels were increased gradually in CHB patients with S1,S2,S3 and S4 of hepatic fibrosis(F=140.309,63.837,82.963,P<0.05).It was proved by ROC analysis that serumβ-arrestin2,HIF-1αand CA125 levels could be used to predict S4 of CHB,with the areas under the curve(AUC)of 0.984,0.926 and 0.956,respectively.The combined diagnosis could obtain a higher AUC as 0.999(P<0.05).Multivariate logistic regression analysis showed thatβ-arrestin2≥96.37 pg/mL(OR=2.011,95%CI:1.211~3.339),HIF-1α≥74.345μg/L(OR=1.696,95%CI:1.026~2.804),CA125≥173.27 U/mL(OR=2.117,95%CI:1.974~3.987)were risk factors for S4.Serumβ-arrestin2,HIF-1a,CA125 levels were positively correlated with hepatic fibrosis stages in CHB patients(r=0.458,0.651,0.531,all P<0.05).Conclusion Seru

关 键 词：血清β-抑制蛋白2 缺氧诱导因子1A 糖类抗原125 慢性乙型肝炎 肝纤维化 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]