慢性乙型肝炎患者血清SIRT6、CHI3L1水平与肝纤维化程度的相关性分析  

Correlation analysis between serum SIRT6,CHI3L1 expression and degree of liver fibrosis in patients with chronic hepatitis B

作　　者：刘红 钱孝先 李响 张志锋 陈春燕 Liu Hong;Qian Xiaoxian;Li Xiang;Zhang Zhifeng;Chen Chunyan(Department of Infectious Diseases,Central Hospital of Minhang District,Shanghai 201199,China;不详)

机构地区：[1]上海市闵行区中心医院感染科,201199 [2]上海市闵行区中心医院消化内科,201199

出　　处：《疑难病杂志》2025年第2期165-169,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：国家自然科学基金资助项目(81900494)。

摘　　要：目的探讨慢性乙型肝炎(CHB)患者血清中沉默信息调节蛋白6(SIRT6)和几丁质酶3-样蛋白1(CHI3L1)水平与肝纤维化严重程度的关系。方法选取2023年3月—2024年4月上海市闵行区中心医院感染科收治的CHB患者124例为研究对象,根据Scheuer评分系统中的纤维化程度分期将患者分为显著肝纤维化组58例和非显著肝纤维化组66例。采用酶联免疫吸附法测定血清SIRT6、CHI3L1水平;多因素Logistic回归分析CHB患者发生显著肝纤维化的影响因素;受试者工作特征(ROC)曲线评价血清SIRT6、CHI3L1水平对CHB患者发生显著肝纤维化的诊断价值。结果显著肝纤维化组血清SIRT6水平低于非显著肝纤维化组,血清CHI3L1水平高于非显著肝纤维化组(t/P=6.719/<0.001、7.546/<0.001);显著肝纤维化组HBeAg阳性人数占比、HBV-DNA含量高于非显著肝纤维化组(χ^(2)/t/P=24.125/<0.001、10.246/<0.001);多因素Logistic回归分析结果显示,血清CHI3L1水平升高是CHB患者发生显著肝纤维化的独立危险因素[OR(95%CI)=2.932(1.554~5.533)],血清SIRT6水平升高是其独立保护因素[OR(95%CI)=0.586(0.435~0.789)];血清SIRT6、CHI3L1水平及二者联合诊断CHB患者发生显著肝纤维化的曲线下面积(AUC)分别为0.897、0.856、0.963,二者联合的AUC大于血清SIRT6、CHI3L1水平单独诊断(Z/P=2.888/0.004、3.676/<0.001)。结论CHB患者血清SIRT6水平降低、CHI3L1水平升高,且与肝纤维化程度有关,两者联合诊断CHB患者肝纤维化程度有一定价值。Objective To investigate the relationship between the expression levels of Sirtuin-6(SIRT6)and Chitinase-3-like protein 1(CHI3L1)in the serum of patients with chronic hepatitis B(CHB)and the severity of liver fibrosis.Methods A total of 124 CHB patients admitted to our hospital between March 2023 and April 2024 were included as the research subjects.According to the Scheuer system scoring results,they were assigned into a significant liver fibrosis group(Scheuer score≥2)of 58 cases and a non-significant liver fibrosis group(Scheuer score<2)of 66 cases.ELISA method was used to detect the levels of serum SIRT6 and CHI3L1.Multivariate logistic regression analysis was applied to determine the risk factors for the degree of liver fibrosis in CHB patients.The diagnostic value of serum SIRT6 and CHI3L1 for the degree of liver fibrosis in CHB patients was analyzed by plotting ROC curves.Results Compared with the non-significant liver fibrosis group,the significant liver fibrosis group showed a significant decrease in serum SIRT6 level and a significant increase in serum CHI3L1 level in CHB patients(t/P=6.719/<0.001,7.546/<0.001).The proportion of HBeAg positive individuals and HBV-DNA level in the significant liver fibrosis group were higher than those in the non-significant liver fibrosis group(t/P=24.125/<0.001,10.246/<0.001).CHI3L1 was an independent risk factor for the degree of liver fibrosis in CHB patients[OR(95%CI)=2.932(1.554-5.533)],while SIRT6 was a protective factor for the degree of liver fibrosis in CHB patients[OR(95%CI)=0.586(0.435-0.789)].The AUC of serum SIRT6,CHI3L1 and value the combined diagnosis for the degree of liver fibrosis in CHB patients was 0.897,0.856,0.963,and the AUC of the combined diagnosis was better than that of the individual diagnosis(Z=2.888,3.676,P=0.004,0.000).Conclusion The serum SIRT6 level is decreased and CHI3L1 level is increased in CHB patients,they are related to the degree of liver fibrosis.The combination of the two has certain value in diagnosing the degree of liver fi

关 键 词：慢性乙型肝炎 肝纤维化程度 沉默信息调节蛋白6 几丁质酶3-样蛋白1 相关性 

分 类 号：R575.1[医药卫生—消化系统]