儿童胆道闭锁肝纤维化趋化因子配体12及其受体4表达情况和临床意义  

Expressions and clinical significance of chemokine ligand 12 and its receptor 4(CXCL12/CXCR4)in children with biliary atresia liver fibrosis

作　　者：张攀 徐珂[1] 刘莹[2] 付妮娜[2] 王莎 Zhang Pan;Xu Ke;Liu Ying;Fu Nina;Wang Sha(Department of Pediatric Surgery,Baoji Maternal and Child Health Hospital,Baoji 721000,China;Department of Clinical Laboratory,Baoji Maternal and Child Health Hospital,Baoji 721000,China)

机构地区：[1]宝鸡市妇幼保健院小儿外科,宝鸡721000 [2]宝鸡市妇幼保健院检验科,宝鸡721000

出　　处：《国际医药卫生导报》2025年第3期435-440,共6页International Medicine and Health Guidance News

基　　金：陕西省重点研发计划(2020SF-059)。

摘　　要：目的分析趋化因子配体12(CXCL12)及趋化因子受体4(CXCR4)在儿童胆道闭锁肝纤维化中的表达情况和临床意义。方法选取2019年5月至2024年5月宝鸡市妇幼保健院收治的100例胆道闭锁肝纤维化患儿为研究组,并对患儿进行纤维化分级,Ⅰ~Ⅱ级36例,Ⅲ~Ⅳ级64例。选取同期入院手术的45例胆总管囊肿患儿为对照组。研究组男47例,女53例;年龄(59.41±5.23)d。对照组男22例,女23例;年龄(60.33±5.48)d。比较两组一般资料[性别、年龄、白细胞计数(WBC)、血小板计数(PLT)、中性粒细胞与淋巴细胞比值(NLR)]、CXCL12及CXCR4蛋白表达水平、肝功能指标[谷丙转氨酶(ALT)、总胆红素(TBil)、谷氨酰转肽酶(GGT)],不同纤维化分级胆道闭锁肝纤维化患儿CXCL12、CXCR4蛋白表达水平。采用独立样本t检验和χ^(2)检验进行统计学分析。采用多因素logistic回归分析胆道闭锁肝纤维化的影响因素。采用受试者操作特征曲线(ROC)分析各指标对胆道闭锁肝纤维化的诊断效能,计算曲线下面积(AUC)。采用散点图分析胆道闭锁肝纤维化患儿CXCL12、CXCR4蛋白表达水平与纤维化分级的相关性。结果研究组CXCL12、CXCR4蛋白表达水平均高于对照组[(1.09±0.26)μg/L比(0.89±0.18)μg/L、(1.04±0.22)μg/L比(0.87±0.19)μg/L](均P<0.05)。研究组血清ALT、TBil、GGT水平均高于对照组[(75.47±23.12)U/L比(62.15±10.33)U/L、(148.26±30.14)μmol/L比(125.27±28.59)μmol/L、(321.87±43.26)U/L比(285.49±38.15)U/L](均P<0.05)。多因素logistic回归分析显示,CXCL12、CXCR4蛋白表达水平和血清ALT、TBil、GGT水平均是胆道闭锁肝纤维化的独立危险因素(均P<0.05)。ROC结果显示,CXCL12、CXCR4蛋白表达水平和血清ALT、TBil、GGT水平联合诊断胆道闭锁肝纤维化的AUC大于单一指标(0.874比0.670、0.642、0.693、0.677、0.720)(均P<0.05)。Ⅲ~Ⅳ级胆道闭锁肝纤维化患儿CXCL12、CXCR4蛋白表达水平均高于Ⅰ~Ⅱ级[(1.54±0.20)μg/L�Objective To analyze the expressions and clinical significance of chemokine ligand 12 and its receptor 4(CXCL12/CXCR4)in children with biliary atresia liver fibrosis.Methods A total of 100 children with biliary atresia liver fibrosis admitted to Baoji Maternal and Child Health Hospital from May 2019 to May 2024 were selected as the study group,and the fibrosis grades were performed,including 36 cases of gradeⅠ-Ⅱand 64 cases of gradeⅢ-Ⅳ.Forty-five children with common bile duct cysts admitted for surgery during the same period were selected as the control group.There were 47 males and 53 females in the study group,aged(59.41±5.23)d.There were 22 males and 23 females in the control group,aged(60.33±5.48)d.The general data[gender,age,white blood cell count(WBC),platelet count(PLT),and neutrophil to lymphocyte ratio(NLR)],expression levels of CXCL12 and CXCR4 protein,and liver function indexes[alanine aminotransferase(ALT),total bilirubin(TBil),and glutamyl transpeptidase(GGT)]of the two groups were compared.And the expression levels of CXCL12 and CXCR4 protein in children with biliary atresia liver fibrosis of different fibrosis grades.Independent sample t test andχ^(2) test were used for statistical analysis.Multivariate logistic regression analysis was used to analyze the influencing factors of biliary atresia liver fibrosis.The receiver operating characteristic curve(ROC)was used to analyze the diagnostic efficiency of each index for biliary atresia liver fibrosis,and the area under the curve(AUC)was calculated.The correlations between the expression levels of CXCL12 and CXCR4 protein and the grade of fibrosis in children with biliary atresia liver fibrosis were analyzed by scatter plot.Results The expression levels of CXCL12 and CXCR4 protein in the study group were higher than those in the control group[(1.09±0.26)μg/L vs.(0.89±0.18)μg/L,(1.04±0.22)μg/L vs.(0.87±0.19)μg/L](both P<0.05).Serum ALT,TBil,and GGT levels in the study group were higher than those in the control group[(75.47±23.12)U

关 键 词：胆道闭锁肝纤维化 儿童 趋化因子配体12 趋化因子受体4 表达情况 临床意义 

分 类 号：R73[医药卫生—肿瘤]