苄氯素1、黏蛋白结构域3、白细胞介素34在急性肝衰竭中的表达及对患者疾病转归的预测价值  

Expression of Beclin1,mucin domain 3 and interleukin-34 in patients with acute liver failure and their predictive value for disease prognosis

作　　者：王刚 巩博 余治国 苏芮 周彬 周春芳 陆卫华 Wang Gang;Gong Bo;Yu Zhiguo;Su Rui;Zhou Bin;Zhou Chunfang;Lu Weihua(Department of Emergency Medicine,General Hospital of the Central Theater Command,Hubei Wuhan 430070,China;Department of Liver Diseases,Taihe Hospital Affiliated to Hubei University of Medicine,Hubei Shiyan 442000,China)

机构地区：[1]中部战区总医院急诊医学科,湖北武汉430070 [2]湖北医药学院附属太和医院肝病科,湖北十堰442000

出　　处：《中国肝脏病杂志（电子版）》2024年第3期45-51,共7页Chinese Journal of Liver Diseases：Electronic Version

基　　金：2022湖北省教育厅科学研究计划指导性项目(B2022135)。

摘　　要：目的探讨苄氯素1(Beclin1)、黏蛋白结构域3(mucin domain 3,TIM-3)、白细胞介素-34(interleukin 34,IL-34)在急性肝衰竭患者中的表达及对疾病转归的预测价值。方法选取2020年1月至2022年1月于中部战区总医院就诊的80例急性肝衰竭患者为急性肝衰竭组,以同期于本院体检的80例健康人群作为健康组。通过酶联免疫吸附试验法测定Beclin1、IL-34表达水平,通过流式细胞术测定TIM-3表达水平,比较两组患者外周血Beclin1、TIM-3、IL-34表达水平差异。急性肝衰竭患者均接受保肝、人工肝或肝移植治疗,根据治疗后疾病转归分为存活组(56例)和死亡组(24例),比较两组患者Beclin1、TIM-3、IL-34的表达水平。采用Pearson相关系数分析Beclin1、TIM-3、IL-34与肝功能指标的相关性,采用多因素Logistic回归分析影响急性肝衰竭患者病情转归的危险因素,采用受试者工作特征(receiver operator characteristic,ROC)曲线分析Beclin1、TIM-3、IL-34对急性肝衰竭患者病情转归的预测效能。结果与健康组比较,急性肝衰竭组患者外周血Beclin1[(13.42±2.11)μg/L比(8.10±1.12)μg/L]、TIM-3[(44.53±3.29)%比(20.19±2.31)%]、IL-34[(15.53±2.05)ng/L比(9.73±1.13)ng/L]表达水平均升高(P<0.05)。Pearson相关性分析显示,急性肝衰竭患者外周血Beclin1、TIM-3、IL-34水平与肝功能指标[总胆红素(total bilirubin,TBil)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)]均呈正相关(P均<0.05)。与存活组患者比较,死亡组患者外周血Beclin1[(15.64±2.13)μg/L比(10.02±1.54)μg/L]、TIM-3[(51.32±6.75)%比(35.64±3.41)%]、IL-34[(19.08±2.43)ng/L比(11.12±1.32)ng/L]表达水平均升高(P<0.05)。多因素Logistic回归分析表明Beclin1(OR=4.536,95%CI:3.442~8.904,P<0.001)、TIM-3(OR=2.342,95%CI:1.023~6.757,P<0.001)、IL-34(OR=5.642,95%CI:3.452~9.089,P<0.001)升高均是影响急性肝衰竭患者疾病转归的独立危险因�Objective To investigate the expression of Beclin1,mucin domain 3(TIM-3)and interleukin-34(IL-34)in patients with acute liver failure and their predictive value for disease outcomes.Methods Total of 80 patients with acute liver failure who received medical treatment in General Hospital of the Central Theater Command from January 2020 to January 2022 were selected as acute liver failure group,and 80 healthy individuals who underwent physical examinations in our hospital during the same period were selected as healthy group.The expression levels of Beclin1 and IL-34 were measured by enzyme-linked immunosorbent assay,and TIM-3 was measured by flow cytometry.All patients with acute liver failure were treated with liver protection,artificial liver or liver transplantation.They were divided into survival group(56 cases)and death group(24 cases)according to the outcome of the disease after treatment.The expression levels of Beclin1,TIM-3 and IL-34 of patients in two groups were compared.Pearson correlation coefficient was used to analyze the correlation between Beclin1,TIM-3,IL-34 and liver function indicators.Multivariate Logistic regression was used to analyze the risk factors affecting the prognosis of acute liver failure patients.Receiver operator characteristic(ROC)curve was used to analyze the predictive value of Beclin1,TIM-3,IL-34 on the prognosis of patients with acute liver failure.Results Compared with those of healthy group,Beclin1[(13.42±2.11)μg/L vs.(8.10±1.12)μg/L],TIM-3[(44.53±3.29)%vs.(20.19±2.31)%]and IL-34[(15.53±2.05)ng/L vs.(9.73±1.13)ng/L]expression levels of patients in acute liver failure group increased significantly(all P<0.05).Pearson correlation analysis showed that the levels of Beclin1,TIM-3 and IL-34 in peripheral blood of patients with acute liver failure were positively correlated with liver function indicators[total bilirubin(TBil),alanine aminotransferase(ALT),aspartate aminotransferase(AST)](all P<0.05).Compared with those of survival group,Beclin1[(15.64±2.13)μg/L vs.(10.02

关 键 词：苄氯素1 黏蛋白结构域3 白细胞介素-34 急性肝衰竭 疾病转归 

分 类 号：R575.3[医药卫生—消化系统]