血清层粘连蛋白、蛋白电泳与肝硬化严重程度的相关性及对轻微型肝性脑病的预测  

The correlation between serum LN,SPE and the severity of liver cirrhosis and their prediction for mild hepatic encephalopathy

作　　者：严兆兰 李雅婧 邓金花 谢玉瑾 YAN Zhaolan;LI Yajing;DENG Jinhua;Xie Yujin(Department of Gastroenterology,The Fourth People’s Hospital of Qinghai,Xining 810000,China)

机构地区：[1]青海省第四人民医院消化内科,西宁810000 [2]青海省第四人民医院内科,西宁810000

出　　处：《传染病信息》2024年第4期329-334,共6页Infectious Disease Information

基　　金：青海省卫健委科研项目(2023-wjzdx-72)。

摘　　要：目的探讨血清层粘连蛋白(laminin,LN)、蛋白电泳(protein electrophoresis,SPE)与肝硬化严重程度的相关性及对合并轻微型肝性脑病的预测价值。方法选取青海省第四人民医院2020年1月至2024年1月收治的200例肝硬化患者作为研究对象,根据肝硬化Child-pugh分级标准分为A级组(n=46),B级组(n=90),C级组(n=64)。对比上述3组患者LN、SPE表达水平,应用Spearman相关性分析法分析LN、SPE与肝硬化严重程度的相关性。随后将200例肝硬化患者依照是否合并轻微型肝性脑病分为肝性脑病组(n=35)与非肝性脑病组(n=165),对比分析2组患者的一般及临床资料,LN及SPE表达水平,Logistics回归模型分析肝硬化合并轻微型肝性脑病的影响因素,建立受试者工作特征(receiver operating characteristic,ROC)曲线分析LN、SPE对合并轻微型肝性脑病的预测价值。结果A级组、B级组及C级组患者间血清LN、SPE水平比较,差异均具有统计学意义,C级组患者γ-球蛋白、α1-球蛋白及LN水平均高于B级组与A级组患者,而β-球蛋白、α2-球蛋白及白蛋白水平均低于B级组与A级组患者(P均<0.05);Spearman相关分析结果显示:γ-球蛋白、α1-球蛋白及LN水平与肝硬化严重程度呈正相关,β-球蛋白、α2-球蛋白及白蛋白水平与肝硬化严重程度呈呈负相关(P均<0.05)。肝性脑病组与非肝性脑病组患者Child-pugh分级、合并肝肾综合征、合并肝硬化腹水、合并电解质紊乱、合并感染、血氨及总胆红素水平对比差异均具有统计学意义(P均<0.05);肝性脑病组与非肝性脑病组α1-球蛋白及白蛋白相关血清SPE水平对比,差异均无统计学意义(P均>0.05),而γ-球蛋白、β-球蛋白、α2-球蛋白相关血清SPE及LN水平对比差异均具有统计学意义(P均<0.05);合并电解质紊乱、合并感染、γ-球蛋白、β-球蛋白、α2-球蛋白相关血清SPE及LN是肝硬化轻微型肝性脑病发生的危险因素(P均>0.05);ROC曲线分�Objective To explore the correlation between serum laminin(LN),protein electrophoresis(SPE)and the severity of liver cirrhosis,and their predictive value for mild hepatic encephalopathy.Method Two hundred patients with liver cirrhosis admitted to our hospital from January 2020 to January 2024 were selected as the research subjects.The severity of liver cirrhosis was determined by Child Pugh grading for all patients,with 46 cases classified as A,90 cases classified as B,and 64 cases classified as C.Compare the expression levels of serum laminin and SPE in patients with different Child Pugh grades,and use Spearman correlation analysis to analyze the correlation between laminin,SPE and the severity of liver cirrhosis.Subsequently,200 patients with cirrhosis were divided into two groups based on whether they had mild hepatic encephalopathy or not,namely the hepatic encephalopathy group(n=35)and the non hepatic encephalopathy group(n=165).Compared with the general clinical data,the expression level of LN and SPE,logistics regression model analyzed the influencing factors of cirrhosis with mild hepatic encephalopathy,and established ROC curve to analyze the predictive value of LN and SPE with mild hepatic encephalopathy.Result The comparison of serum LN and SPE levels among patients in Class A,Class B,and Class C groups showed statistically significant differences.The levels of gamma globulin,α1-globulin,and LN in patients with grade C were higher than those in patients with grade B and grade A,while the levels of beta globulin,α2-globulin,and albumin in patients with grade C were lower than those in patients with grade B and grade A(P<0.05);The Spearman correlation analysis results showed thatγ-globulin,α1-globulin,and LN were positively correlated with the severity of liver cirrhosis,whileβ-globulin,α2-globulin,and albumin were negatively correlated with the severity of liver cirrhosis(P<0.05);There were significant differences(P<0.05)in Child Pugh grading,hepatorenal syndrome,ascites,electrolyte imbalance,infe

关 键 词：层粘连蛋白 蛋白电泳 肝硬化 CHILD-PUGH分级 轻微型肝性脑病 预测价值 

分 类 号：R557.2[医药卫生—血液循环系统疾病]