摘要
目的研究慢加急性肝衰竭(ACLF)患者血清高尔基体蛋白73(GP73)的表达影响因素及其与短期(3个月)预后的关系,探索新的预测ACLF预后的指标。方法选取宁波市第二医院2010年1月-2014年8月299例住院患者,按疾病类型分为慢性肝炎组91例,肝硬化组74例,ACLF组134例,另选同期45名健康体检者作为对照组,比较各组GP73水平。134例ACLF患者按随访第3个月的情况分成生存组和死亡组,记录临床特征,收集基线及随访第2周血清检测GP73浓度,应用受试者工作特征曲线(ROC)曲线下面积评价随访第2周的血清GP73对ACLF患者预后的预测价值。结果 ACLF患者血清GP73浓度显著高于正常对照组、慢性肝炎和肝硬化患者(P<0.05);性别、年龄、肝功能child-pugh评分、合并肝癌与否对ACLF患者血清GP73浓度均无影响,而肝硬化的有无与血清GP73浓度密切相关(P<0.01),同时酒精性ACLF患者血清GP73浓度显著高于HBV感染者(P=0.027);生存组和死亡组的基线GP73浓度差异无统计学意义,而随访第2周血清GP73浓度及GP73的变化率差异均有统计学意义(P<0.05);ROC曲线提示血清GP73对ACLF的预后有一定的预测价值(AUC=0.731)。结论血清GP73有可能作为一种有效的预测ACLF患者预后的指标,特别是动态观察有较重要的临床意义。
OBJECTIVE To explore the influencing factors for expression of serum Golgi protein 73 （GP73） in pa- tients with acute-on-chronic liver failure （ACLF） , observe the relationship between the serum GP73 and the short-term （3 months） prognosis, and seek novel indicators for prediction of the prognosis of ACLF. METHODS A total of 299 patients who were hospitalized Ningbo No. 2 Hospital from Jan 2010 to Aug 2014 were enrolled in the study and divided into the chronic hepatitis group with 91 cases, the cirrhosis group with 74 cases, and the ACLF group with 134 cases according to the types of diseaseS, meanwhile, 45 healthy people who received the physical examination were set as the control group. The GP73 level was compared. The ACLF patients were divided into the survival group and the death group according to the status of the third month of follow-up, the clinical charac- teristics were recorded, the serum GP73 levels were measured at baseline and the 2nd week of follow-up, and the area under the receiver operating characteristic （ROC） curve was applied to evaluate the value of serum GP73 in the 2nd week of follow-up in prediction of prognosis of the patients with ACLF. RESULTS The serum GP73 con- centration of the patients with ACLF was significantly higher than that of the participants in the control group, the patients with chronic hepatitis, and the patients with cirrhosis （P〈0.05）. The serum GP73 concentration of the patients with ACLF could not be influenced by the gender, age, liver function ehild-pugh score, or complication with liver cancer, however, the liver cirrhosis was closely associated with the serum GP73 concentration （P〈 0.01） ; the serum GP73 concentration of the patients with alcoholic ACLF was significantly higher than that of the patients with HBV infection （P=0. 027）. There was no significant difference in the baseline GP73 concentration between the survival group and the death group, however, there was significant difference in the serum GP73 con- centration in
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第21期4894-4896,共3页
Chinese Journal of Nosocomiology
基金
国家973计划基金资助项目(2012CB518900)
中国肝炎防治基金会-天晴肝病研究基金资助项目(TQGB20120081)
浙江省医药卫生省部培育计划基金资助项目(2014PYA018)
