慢性乙型肝炎患者microRNA表达及其对肝纤维化分期的诊断价值  

Expression of microRNA in patients with chronic hepatitis B and its value in diagnosis of hepatic fibrosis stage

作　　者：钟雷 章勇 徐芊 许伟 ZHONG Lei;ZHANG Yong;XU Qian;XU Wei(LianyungangDongfang Hospital,Lianyungang,Jiangsu 222042,China)

机构地区：[1]连云港市立东方医院检验科,江苏连云港222042 [2]连云港市立东方医院感染科,江苏连云港222042

出　　处：《中华医院感染学杂志》2025年第1期35-39,共5页Chinese Journal of Nosocomiology

基　　金：江苏省卫生健康委科研项目(BJ20310)。

摘　　要：目的探讨慢性乙型肝炎(CHB)患者微小核糖核酸(miR)表达及其诊断肝纤维化(HF)分期的临床价值。方法选取2021年1月-2023年10月连云港市立东方医院接受治疗的85例CHB患者作为病例组,并根据纤维化分期进一步分为无或轻度HF组53例(S0~S1期)和显著HF组32例(≥S2期),另选取同期于医院体检的健康者89名为对照组,比较三组肝功能指标、HF指标及miR-34a、miR-29b、miR-21、miR-122水平,采用受试者工作特征(ROC)曲线分析血清miR-34a、miR-29b、miR-21、miR-122水平评估CHB患者纤维化分期≥S2期的诊断效能。结果三组肝功能指标血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBil)等及HF指标透明质酸(HA)、层黏连蛋白(LN)、Ⅳ型胶原(C-Ⅳ)、Ⅲ型前胶原(PC-Ⅲ)比较均有统计学差异(P<0.05),且显著HF组各指标水平更高(P<0.05)。三组血清miR-34a、miR-29b、miR-21、miR-122水平比较差异有统计学意义(P<0.05),其中显著HF组血清miR-34a、miR-29b水平更低(均P<0.05),血清miR-21水平更高(P<0.05),显著HF组和无或轻度HF组血清miR-122水平均高于对照组(P<0.05),但显著HF组低于无或轻度HF组(P<0.05)。miR-34a、miR-29b、miR-21、miR-122联合检测诊断CHB患者纤维化分期≥S2期的曲线下面积(AUC)为0.830,敏感度和特异度分别为78.12%和77.36%。结论CHB患者肝功能异常与HF程度存在一定联系,且miR-34a、miR-29b、miR-21、miR-122对CHB患者纤维化分期≥S2期具有较高的评估价值,且联合检测评估价值更高。OBJECTIVE To explore the expression of microribonucleic acid(miR)in the patients with chronic hepatitis B(CHB)and analyze the value in diagnosis of the hepatic fibrosis(HF)stage.METHODS Totally 85 patients with CHB who were treated in Lianyungang Dongfang Hospital from Jan.2021 to Oct.2023 were assigned as the case group and were further divided into the no HF or mild HF group with 53 cases(SO to S1 stage)and the remarkable HF group with 32 cases(no less than S2 state)according to the stage of HF.Meanwhile,89 healthy individuals who received physical examination were chosen as the control group.The liver function indexes,HF indexes,miR-34a,miR-29b,miR-21 and miR-122 were compared among the three groups.The efficiencies of the serum miR-34a,miR-29b,miR-21 and miR-122 in diagnosis of the no less than S2 stage of HF were evaluated by means of receiver operating characteristic(ROC)curves.RESULTS There were significant differences in the liver function indexes such as serum alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBil)as well as the HF indexes hyaluronic acid(HA),laminin(LN),type IV collagen(C-IV)and type II procollagen(PC-II)among the three groups(P<0.05),and the levels of the above indexes were higher in the remarkable HF group(P<0.05).There were significant differences in the levels of serum miR-34a,miR-29b,miR-21 and miR-122 among the three groups(P<0.05),the levels of serum miR-34a and miR-29b were lower in the remarkable HF group(P<0.05),and the serum miR-21 was higher(P<0.05);the serum miR-122 level of the remarkable HF group and the no or mild HF group was higher than that of the control group(P<o.O5),but the serum miR-122 level of the remarkable HF group was lower than that of the no or mild HF group(P<0.05).The area under the curve(AUC)of the joint detection of miR-34a,miR-29b,miR-21 and miR-122 was 0.830 in diagnosis of the no less than S2 stage of HF in the patients with CHB,with the sensitivity 78.12%,the specificity 77.36%.CONCLUSION There is certain association b

关 键 词：乙型肝炎病毒 慢性乙型肝炎 肝功能 微小核糖核酸 肝纤维化 

分 类 号：R512.6[医药卫生—内科学]