慢性乙型病毒性肝炎肝硬化患者病情严重程度及预后研究  

Study on the severity and prognosis of patients with chronic hepatitis B virus-induced liver cirrhosis

作　　者：李飞飞 张春阳 Li Feifei;Zhang Chunyang(Physical Examination Center,Pingdingshan Second People′s Hospital,Pingdingshan 467000,China)

机构地区：[1]平顶山市第二人民医院体检中心,平顶山467000

出　　处：《实用医技杂志》2024年第7期493-497,共5页Journal of Practical Medical Techniques

摘　　要：目的分析血清血管内皮生长因子(VEGF)、结缔组织生长因子(CTGF)、高迁移率蛋白B-1(HMGB-1)、凝血酶原国际标准化比值/白蛋白(PTAR)评估慢性乙型病毒性肝炎(CHB)肝硬化患者的病情严重程度与预后的效果。方法以2020年3月至2022年3月平顶山市第二人民医院收治的CHB肝硬化患者89例为观察组,以同期平顶山市第二人民医院收治的单纯CHB患者85例为对照组,另将同期在平顶山市第二人民医院体检的体检健康者91名为健康组,采集3组晨起空腹静脉血,检测对比其血清VEGF、CTGF、HMGB-1、PTAR的差异;将观察组患者依据其肝功能Child-Pugh分级分为A级、B级、C级三个亚组,检测对比3亚组间的VEGF、CTGF、HMGB-1、PTAR差异;随访1年,依据患者的临床结局(生存或死亡)将观察组患者分为预后良好与预后不良2个亚组,统计对比两个亚组VEGF、CTGF、HMGB-1、PTAR之间的差异。结果观察组的VEGF为(170±15)pg/ml、CTGF为(229±16)ng/L、HMGB-1为(40.2±8.3)ng/ml、PTAR为(0.061±0.020),高于对照组[(138±11)pg/ml,t=15.724,P<0.05;(196±12)ng/L,t=14.762,P<0.05;(29.0±4.6)ng/ml,t=10.952,P<0.05;(0.051±0.011),t=4.141,P<0.05];同时高于与健康组的[(90±6)pg/ml,t=46.303,P<0.05;(88±4)ng/L,t=79.671,P<0.05;(20.3±2.5)ng/ml,t=21.838,P<0.05;(0.032±0.012),t=12.771,P<0.05]。对照组的VEGF、CTGF、HMGB-1、PTAR高于健康组,差异有统计学意义(t=37.739、78.332、15.742、13.259,P<0.05)。C级组的VEGF、CTGF、HMGB-1、PTAR高于B级组、A级组,且B级组的各项指标高于A级组,差异有统计学意义(P<0.05);预后不良组的VEGF、CTGF、HMGB-1、PTAR高于预后良好组,差异有统计学意义(P<0.05)。结论VEGF、CTGF、HMGB-1、PTAR在CHB肝硬化患者机体内呈异常高表达,能够有效评估患者的病情严重程度与预后。Objective To analyze the effect of serum vascular endothelial growth factor(VEGF),connective tissue growth factor(CTGF),high mobility protein B-1(HMGB-1),and prothrombin time-international normalized ratio-to-albumin ratio(PTAR)on evaluating the severity and prognosis of chronic hepatitis B(CHB)in patients with liver cirrhosis.Methods Eighty-nine patients with CHB cirrhosis admitted to the Second People′s Hospital of Pingdingshan City from March 2020 to March 2022 were selected as the observation group,85 patients with simple CHB admitted to the Second People′s Hospital of Pingdingshan City during the same period were selected as the control group,and 91 healthy individuals who underwent physical examinations at the Second People′s Hospital of Pingdingshan City during the same period were selected as the healthy group.Fasting venous blood was collected from the three groups in the morning,and the differences in serum VEGF,CTGF,HMGB-1,and PTAR were detected and compared;Divide the observation group patients into three subgroups A,B,and C based on their Child Pugh grading of liver function,and compare the differences in VEGF,CTGF,HMGB-1,and PTAR among the three subgroups;Follow up for 1 year,the observation group patients were divided into two subgroups based on their clinical outcomes(survival or death):good prognosis and poor prognosis.The differences in VEGF,CTGF,HMGB-1,and PTAR between the two subgroups were statistically compared.Results The VEGF of the observation group was(170±15)pg/ml,CTGF was(229±16)ng/L,HMGB-1 was(40.2±8.3)ng/ml,and PTAR was(0.061±0.020),which was higher than the control groups[(138±11)pg/ml,t=15.724,P<0.05;(196±12)ng/L,t=14.762,P<0.05;(29.0±4.6)ng/ml,t=10.952,P<0.05;(0.051±0.011),t=4.141,P<0.05;respectively],while the healthy groups[(90±6)pg/ml,t=46.303,P<0.05;(88±4)ng/L,t=79.671,P<0.05;(20.3±2.5)ng/ml,t=21.838,P<0.05;(0.032±0.012),t=12.771,P<0.05].VEGF,CTGF,HMGB-1 in the control group PTAR were higher than those of the healthy group,with statistical differences(t=37.73

关 键 词：病毒性肝炎 乙型 慢性 肝硬化 血管表皮生长因子 结缔组织生长因子 预后 白蛋白 

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