β-珠蛋白生成障碍性贫血患者血清FABP4,FGF19水平表达及与预后的关系  

Expression of Serum FABP4 and FGF19 Levels in Patients withβ-Thalassemia and Their Relationship with Prognosis

作　　者：陈艺心 潘锋[2] 徐娅 彭鑫 梁露 李茹靖 李聪[2] 曾红鑫 CHEN Yixin;PAN Feng;XU Ya;PENG Xin;LIANG Lu;LI Rujing;LI Cong;ZENG Hongxin(Department of Blood Transfusion,Qianjiang Hospital Affiliated to Chongqing University,Chongqing 409000,China;Department of Laboratory,Qianjiang Hospital Affiliated to Chongqing University,Chongqing 409000,China)

机构地区：[1]重庆大学附属黔江医院输血科,重庆409000 [2]重庆大学附属黔江医院检验科,重庆409000

出　　处：《现代检验医学杂志》2024年第5期96-101,共6页Journal of Modern Laboratory Medicine

基　　金：重庆市卫生健康委员会医学科研项目(2022WSJK016);吉首大学指导性项目(Jdzd23026);黔江区科技计划项目(黔科技2024009)。

摘　　要：目的研究β-珠蛋白生成障碍性贫血(beta-thalassaemia,β-TM)患者血清脂肪酸结合蛋白4(fatty acidbindingprotein 4,FABP4)、纤维细胞生长因子19(fibroblast growth factor 19,FGF19)表达及其与预后的关系。方法选取2018年1月~2020年8月重庆大学附属黔江医院诊治的112例β-珠蛋白生成障碍性贫血患者为病例组,选取同期体检的60例健康人为对照组。采用酶联免疫吸附实验(ELISA)检测血清FABP4和FGF19水平。Logistic回归模型分析β-珠蛋白生成障碍性贫血患者预后影响因素。受试者工作特征(ROC)曲线分析血清FABP4和FGF19对β-珠蛋白生成障碍性贫血患者预后的预测价值。结果病例组患者血清FABP4(67.13±11.35μg/L)水平高于对照组(22.01±4.16μg/L),血清FGF19(104.24±21.46 ng/L)水平低于对照组(218.01±36.79 ng/L),差异均具有统计学意义(t=29.708,25.620,均P<0.05)。轻型组、中间型组及重型组患者血清FABP4水平(54.20±12.63μg/L,66.83±10.5μg/L,79.72±11.05μg/L)依次升高,而FGF19水平(122.53±22.36 ng/L,103.16±20.37 ng/L,86.53±18.14 ng/L)依次降低,差异具有统计学意义(F=39.701,24.231,均P<0.05)。相比于生存组,死亡组患者血清FGF19(62.80±22.09 ng/L vs 110.16±20.69 ng/L),血红蛋白、杂合子基因型比例(βCD17/βN,βCD41-42/βN)较低,而血清FABP4(116.69±12.30 ng/L vs 60.05±10.17 ng/L),铁蛋白及心脏增大比例较高,差异具有统计学意义(t/χ^(2)=4.436~18.981,均P<0.05)。FGF19(OR=0.634,95%CI:0.451~0.891)是β-珠蛋白生成障碍性贫血患者预后的独立保护因素(P<0.001),血清FABP4(OR=1.840,95%CI:1.193~2.838)为预后独立危险因素(P<0.001)。血清FABP4,FGF19联合对β-珠蛋白生成障碍性贫血患者预后评估的曲线下面积(95%CI)为0.897(0.853~0.951),大于单指标检测0.842(0.801~0.879)和0.814(0.762~0.858),差异具有统计学意义(Z=4.864,5.270,P=0.002,0.001)。结论β-珠蛋白生成障碍性贫血患者血清FABP4升高,FGF19降低。血清FABP4,FGF19联合检测对βObjective To explore the expression of serum fatty acid-binding protein 4(FABP4)and fibroblast growth factor 19(FGF19)in patients withβ-thalassemia and their relationship with clinical prognosis.Methods A total of 112 cases ofβ-thalassemia patients diagnosed and treated in Qianjiang Hospital Affiliated to Chongqing University from January 2018 to August 2020 were selected as the case group,and 60 healthy individuals who underwent physical examinations during the same period were taken as the control group.Enzyme-linked immunosorbent assay was used to detect levels of serum FABP4 and FGF19 expression.Multivariate logistic regression analysis was used to analyze factors affecting the prognosis of patients withβ-thalassemia.Receiver operating characteristic curve was used to analyze the prognostic value of FABP4 and FGF19 in patients withβ-thalassemia.Results The serum FABP4 level(67.13±11.35μg/L)in the case group was higher than that in the control group(22.01±4.16μg/L),while the serum FGF19 level(104.24±21.46 ng/L)was lower than that in the control group(218.01±36.79 ng/L),with significant differences(t=29.708,25.620,all P<0.05).The serum FABP4 levels(54.20±12.63μg/L,66.83±10.5μg/L,79.72±11.05μg/L)in the mild group,intermediate group,and severe group were increased sequentially,while FGF19 levels(122.53±22.36 ng/L,103.16±20.37 ng/L,86.53±18.14 ng/L)were decreased sequentially,and the differences were significant(F=39.701,24.231,all P<0.05).Compared to the survival group,serum FGF19 level(62.80±22.09 ng/L vs 110.16±20.69 ng/L),Hb and the proportion of heterozygous genotypes in the death group patients(βCD17/βN,βCD41-42/βN)was lower,while serum FABP4(116.69±12.30 ng/L vs 60.05±10.17 ng/L),ferritin and the proportion of cardiac enlargement were higher,with significant differences(t/χ^(2)=4.436~18.981,all P<0.05).FGF19(OR=0.634,95%CI:0.451~0.891)was an independent protective factor forβ-thalassemia patients(P<0.001),and serum FABP4(OR=1.840,95%CI:1.193~2.838)was an independent risk factor

关 键 词：Β-珠蛋白生成障碍性贫血 脂肪酸结合蛋白4 纤维细胞生长因子19 

分 类 号：R556.61[医药卫生—血液循环系统疾病] R392.11[医药卫生—内科学]