乙型肝炎肝硬化患者血清LN、HA、CⅣ、PⅢ、CHI3L1水平对肝纤维化程度的评估价值  

Evaluation Value of Serum LN,HA,CⅣ,PⅢand CHI3L1 Levels on the Degree of Liver Fibrosis in Patients with Hepatitis B Cirrhosis

作　　者：黄滨宁 HUANG Binning(Department of Laboratory,Xiamen Hongai Hospital,Xiamen 361000,China)

机构地区：[1]厦门弘爱医院检验科,厦门361000

出　　处：《中国医药指南》2024年第34期37-39,共3页Guide of China Medicine

摘　　要：目的探究乙型肝炎肝硬化患者血清层粘连蛋白(LN)、透明质酸(HA)、Ⅳ型胶原(CⅣ)、Ⅲ型前胶原N端肽(PⅢ)、壳多糖酶3样蛋白1(CHI3L1)水平对肝纤维化程度的评估价值。方法以回顾性研究方式选取2023年9月至2024年3月乙型肝炎肝硬化患者111例,根据肝纤维化程度将其分为无显著纤维化组(50例)、显著纤维化组(61例),另选取同期健康体检者31名为对照组,比较三组血清LN、HA、CⅣ、PⅢ、CHI3L1水平,分析血清LN、HA、CⅣ、PⅢ、CHI3L1水平与肝纤维化程度的相关性及评估价值。结果显著纤维化组血清HA、CⅣ、PⅢ、CHI3L1水平较无显著纤维化组、对照组更高(均P<0.05);通过Spearman相关检验显示,血清HA、CⅣ、PⅢ、CHI3L1水平与乙型肝炎肝硬化患者肝纤维化程度呈正相关(r=0.464、0.591、0.285、0.372,均P<0.05);血清LN、PⅢ、CHI3L1、HA、CⅣ水平及联合检测预测患者显著纤维化的曲线下面积(AUC)分别为0.524、0.665、0.716、0.746、0.843、0.875。结论乙型肝炎肝硬化患者血清HA、CⅣ、PⅢ、CHI3L1水平明显升高,其血清水平与乙型肝炎肝硬化患者肝纤维化程度密切相关,各指标联合检测对评估肝纤维化程度具有一定临床应用价值。Objective To investigate the value of serum laminin(LN),hyaluronic acid(HA),typeⅣcollagen(CⅣ),typeⅢprocollagen N-terminal peptide(PⅢ)and chitosinase 3-like protein-1(CHI3L1)in evaluating the degree of liver fibrosis in patients with hepatitis B cirrhosis.Methods A retrospective study was conducted to select 111 patients with hepatitis B cirrhosis from September 2023 to March 2024,and according to the degree of hepatic fibrosis,they were divided into the group with no significant fibrosis(50 cases),the group with significant fibrosis(61 cases),and 31 cases of healthy medical check-ups during the same period were selected as the control group,and the serum LN,HA,CⅣ,PⅢ,CHI3L1 levels of the three groups were compared,analyse the correlations and assess the value of the serum LN,HA CⅣ,PⅢ,CHI3L1 levels and the degree of hepatic fibrosis,and the correlation and assessment value.Results Serum HA,CⅣ,PⅢ,and CHI3L1 levels were higher in the group with significant fibrosis than in the group without significant fibrosis and the control group(all P<0.05).Serum HA,CⅣ,PⅢ,and CHI3L1 levels were positively correlated with the degree of hepatic fibrosis in cirrhotic patients with hepatitis B,as indicated by Spearman correlation test(r=0.464,0.591,0.285,0.372,all P<0.05).The area under the curve(AUC)of serum LN,PⅢ,CHI3L1,HA,CⅣlevels and the combined assay for predicting significant fibrosis in the patients were 0.524,0.665,0.716,0.746,0.843,0.875,respectively.Conclusions Serum levels of HA,CⅣ,PⅢand CHI3L1 in patients with hepatitis B cirrhosis are significantly increased,and their serum levels are closely related to the degree of liver fibrosis in patients with hepatitis B cirrhosis.The combined detection of these indicators has certain clinical value in evaluating the degree of liver fibrosis.

关 键 词：乙型肝炎肝硬化 层粘连蛋白 透明质酸 Ⅳ型胶原 Ⅲ型前胶原N端肽 肝纤维化程度 

分 类 号：R512.62[医药卫生—内科学] R657.31[医药卫生—临床医学]