GP73、IL-2R、miR-21预测慢性乙肝患者显著肝纤维化的临床价值  

Clinical value of GP73,IL-2R and miR-21 in predicting significant hepatic fibrosis in patients with chronic hepatitis B

作　　者：李述美 刘冰 刘仁伟[2] 杨洁 LI Shumei;LIU Bing;LIU Renwei;YANG Jie(Clinical Medicine School of Southwest Medical University,Luzhou,Sichuan 646000,China;Department of Infection,Mianyang 404 Hospital/Mianyang Municipal First People’s Hospital,Mianyang,Sichuan 621000,China)

机构地区：[1]西南医科大学临床医学院,四川泸州646000 [2]四川绵阳四0四医院/绵阳市第一人民医院感染科,四川绵阳621000

出　　处：《重庆医学》2024年第23期3575-3580,共6页Chongqing Medical Journal

基　　金：四川省卫生和计划生育委员会科研课题(18PJ342)。

摘　　要：目的探讨血清高尔基体蛋白73(GP73)、白细胞介素-2受体(IL-2R)、微小核糖核酸-21(miR-21)预测慢性乙型病毒性肝炎(CHB)患者显著肝纤维化的临床价值。方法收集2020年1月至2022年12月绵阳四0四医院收治的106例CHB患者为研究对象,根据肝纤维化程度分类和临床数据,将S0~S1期作为轻度肝纤维化组(n=80),S2~S4期作为显著肝纤维化组(n=26)。分析血清GP73、IL-2R、miR-21与CHB患者显著肝纤维化的相关性,以发生显著肝纤维化为因变量,纳入性别、年龄、BMI、血清GP73、IL-2R、miR-21、乙型肝炎DNA载量及抗HBs进行逐步logistic回归分析,并采用受试者工作特征(ROC)曲线分析诊断效能。结果与轻度肝纤维化组比较,显著肝纤维化组GP73、IL-2R、miR-21水平更高,差异有统计学意义(P<0.05)。CHB患者血清GP73(r=0.472)、IL-2R(r=0.625)、miR-21(r=0.663)水平与显著肝纤维化呈正相关(P<0.001)。多因素分析结果显示,血清GP73、IL-2R为CHB患者显著肝纤维化的独立影响因素(P<0.05),基于GP73≥150.75 ng/mL、IL-2R≥698.6 pg/mL,可对CHB患者显著肝纤维化的发生率进行预测。三者联合诊断显著肝纤维化的AUC最大(0.976),灵敏度(96.2%)和特异度(90.0%)最高。结论血清GP73、IL-2R联合miR-21对显著肝纤维化有较好预测价值。Objective To investigate the serum Golgi transmembrane protein 73(GP73)and interleukin-2 receptor(IL-2R)and microribonucleic acid-21(miR-21)in predicting significant hepatic fibrosis in the patients with chronic hepatitis B(CHB).Methods A total of 106 patients with CHB admitted and treated in Mianyang 404 Hospital from January 2020 to December 2022 were collected as the study subjects.According to the classification of liver fibrosis degree and clinical data,the stage S0-S1 served as the mild liver fibrosis group(n=80)and the stage S2-S4 as the significant liver fibrosis group(n=26).The correlation between serum GP73,IL-2R and miR-21 with significant liver fibrosis was analyzed.The significant liver fibrosis occurrence served as the dependent variable,the sex,age,BMI,serum GP73,IL-2R,miR-21,HBV DNA load and anti-HBS were included to conduct the stepwise Logistic regression analysis.The receiver operating characteristic(ROC)curve was adopted to analyze the diagnostic efficiency.Results Compared with the mild liver fibrosis group,the serum GP73,IL-2R and miR-21 levels in the significant liver fibrosis group were higher,and the difference was statistically significant(P<0.05).The serum GP73(r=0.472),IL-2R(r=0.625)and miR-21(r=0.663)levels were positively correlated with the significant liver fibrosis,and the difference was statistically significant(P<0.001).The multivariate analysis results showed that the serum GP73 and IL-2R were the independent influencing factors of significant liver fibrosis in the patients with CHB.Based on GP73≥150.75 ng/mL and IL-2R≥698.6 pg/mL,which could predict the probability of significant liver fibrosis occurrence in the patients with CHB.The area under the curve(AUC)of the three combination for diagnosing significant liver fibrosis was the greatest(0.976),the sensitivity(96.2%)and specificity(90.0%)were the highest.Conclusion The serum GP73,IL-2R and miR-21 combination has good predictive value for significant liver fibrosis.

关 键 词：慢性乙型肝炎 高尔基体蛋白73 白细胞介素-2受体 微小核糖核酸-21 显著肝纤维化 临床价值 

分 类 号：R512.62[医药卫生—内科学]