外周血PCⅢ、HPX水平与非酒精性脂肪性肝炎患者血脂、肝纤维化的关系  

Relationship of peripheral blood PCⅢand HPX levels with blood lipid and liver fibrosis in patients with nonalcoholic steatohepatitis

作　　者：史良玉 吉婷婷 雷蕾 王玲玲 文思敏 SHI Liangyu;JI Tingting;LEI Lei;WANG Lingling;WEN Simin(Department of Gastroenterology,Shaanxi Provincial Nuclear Industry 215 Hospital,Xianyang,Shaanxi 712000,China)

机构地区：[1]陕西省核工业二一五医院消化内科,陕西咸阳712000

出　　处：《国际检验医学杂志》2025年第2期175-179,共5页International Journal of Laboratory Medicine

基　　金：咸阳市重点研发计划项目(L2022ZDYFSF027)。

摘　　要：目的探讨外周血Ⅲ型前胶原(PCⅢ)、血红素结合蛋白(HPX)水平与非酒精性脂肪性肝炎(NASH)患者血脂、肝纤维化的关系。方法选取2021年1月至2023年12月该院收治的126例NASH患者作为NASH组,根据肝纤维化程度分为无肝纤维化组(22例)、轻度组(63例)、中重度组(41例)。另选取同期该院150例体检健康者作为对照组。采用酶联免疫吸附试验(ELISA)检测并比较各组外周血PCⅢ、HPX水平,采用Pearson相关分析探讨NASH患者外周血PCⅢ、HPX水平与血脂相关指标的相关性,采用受试者工作特征(ROC)曲线评估外周血PCⅢ、HPX对NASH患者肝纤维化的预测价值。结果NASH组外周血PCⅢ、HPX水平,以及总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平高于对照组,高密度脂蛋白胆固醇(HDL-C)水平低于对照组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,NASH患者外周血PCⅢ、HPX水平与TC、TG、LDL-C均呈正相关(P<0.05),与HDL-C均呈负相关(P<0.05)。无肝纤维化组外周血PCⅢ、HPX水平低于轻度组、中重度组,且轻度组低于中重度组,差异有统计学意义(P<0.05)。外周血PCⅢ、HPX预测NASH患者肝纤维化的曲线下面积(AUC)分别为0.757、0.861,截断值分别为135.51 ng/mL、804.86 mg/L,联合预测的AUC为0.905,高于二者单独预测。结论外周血PCⅢ、HPX水平升高与NASH患者血脂水平、肝纤维化程度密切相关,可作为预测NASH患者肝纤维化的潜在生物标志物。Objective To investigate the relationship between the levels of type Ⅲ procollagen(PCⅢ)and heme-binding protein(HPX)in peripheral blood,blood lipid and liver fibrosis in patients with nonalcoholic steatohepatitis(NASH).Methods Totally 126 patients with NASH admitted to the hospital from January 2021 to December 2023 were selected as NASH group,and they were divided into 3 subgroups according to the degree of liver fibrosis:no liver fibrosis group(22 cases),mild group(63 cases),moderate and severe group(41 cases).In addition,150 healthy subjects in the same period were selected as the control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect and compare the levels of PCⅢ and HPX in peripheral blood of all groups,and Pearson correlation analysis was used to explore the correlation between peripheral blood PCⅢ and HPX levels and related indexes of blood lipids in NASH patients.The predictive value of peripheral blood PCⅢ and HPX for liver fibrosis in NASH patients was evaluated by receiver operating characteristic(ROC)curve.Results The levels of PCⅢ and HPX,as well as total cholesterol(TC),triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)in NASH group were higher than those in control group,and the levels of high density lipoprotein cholesterol(HDL-C)were lower than those in control group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that the levels of PCⅢ and HPX in peripheral blood of NASH patients were positively correlated with TC,TG and LDL-C(P<0.05),while negatively correlated with HDL-C(P<0.05).The levels of PCⅢ and HPX in peripheral blood of the non-fibrosis group were lower than those of the mild and moderate severe groups,and the mild group was lower than that of the moderate and severe group,and the differences were statistically significant(P<0.05).The area under the curve(AUC)of peripheral blood PCⅢ and HPX in predicting liver fibrosis in NASH patients were 0.757 and 0.861,respectively,and the cut-off values w

关 键 词：非酒精性脂肪性肝炎 Ⅲ型前胶原 血红素结合蛋白 血脂 肝纤维化 

分 类 号：R575.5[医药卫生—消化系统] R446.1[医药卫生—内科学]