摘要
目的探索血清mi RNA-122在乙型病毒肝炎及晚期肝纤维化患者中的表达及其临床意义。方法采用前瞻性非随机对照法,选取2014年3月至2016年6月在宝鸡市人民医院进行肝穿刺活检的乙型肝炎患者320例和健康对照者310例。参照2010年病毒性肝炎防治方案进行纤维化分期。RT-q PCR法检测血清mi RNA122,ROC分析mi RNA-122对乙肝患者肝纤维化程度的预测价值。结果 320例乙肝患者纤维化分期S_(0-1)者98例,S_2者82例,S_3者66例,S4者74例。健康对照者血清mi RNA-122(1.00±0.09)显著低于S_(0-1)(4.76±1.13,t=21.52,P<0.001)、S2(3.97±0.85,t=22.43,P<0.001)、S_3(2.83±0.56,t=20.72,P<0.001)和S_4(2.48±0.41,t=22.34,P<0.001)组乙肝患者。血清mi R122与肝纤维化分期(S0,1,2,3,4)呈负相关(r=-0.328,P=0.033)。AST、HBV-DNA、ALB、PLT、FIB-4、APRI、mi RNA-122是乙肝患者晚期肝纤维化的独立危险因素。血清mi RNA-122对不同肝纤维化程度乙肝患者的预测价值能效较好(P<0.05),尤其是晚期纤维化组(S_3+S_4组)和肝硬化组(S_4组)能效更佳(AUC>0.700,敏感性和特异性均>70%,P<0.05)。结论血清mi RNA-122可作为乙肝患者无创纤维化评价指标,尤其是针对晚期纤维化乙肝患者。
Objective To investigate the expression and clinical significance of serum miRNA-122 in patients with hepatitis B and advanced liver fibrosis.Methods A prospective and non-randomized controlled trial was conducted in 320 patients with hepatitis B and 310 healthy controls from Mar.2014 to Jun.2016 in Baoji People's Hospital.Fibrosis staging was performed according to the guideline of Viral Hepatitis Prevention and Therapy in 2010.Serum miRNA122 was detected by RT-q PCR.ROC analysis were used to predict the diagnosis value of miRNA-122 for liver fibrosis in patients with hepatitis B.Results There were 98 cases with S0-1 fibrosis staging,S2 in 82 cases,S3 in 66 cases,and S4 in 74 cases.Serum miRNA-122 was significantly lower in healthy controls(1.00± 0.09) than those in patients with S0-1(4.76±1.13,t=21.52,P〈0.001),S2(3.97±0.85,t=22.43,P〈0.001),S3(2.83±0.56,t=20.72,P〈0.001) or S4(2.48±0.41,t=22.34,P〈0.001).Serum miRNA-122 was negatively correlated with hepatic fibrosis staging(S0,1,2,3,4)(r=-0.328,P=0.033).AST,HBV-DNA,ALB,PLT,FIB-4,APRI,miRNA-122 were the dependent risk factors for advanced fibrosis.The predictive value of the serum miRNA-122 was effective on different liver fibrosis stage in patients with hepatitis B(P〈0.05),especially on advanced fibrosis group(S3+S4) and cirrhosis group(S4)(AUC〉0.700,sensitivity and specificity were all 〉70%,P〈0.05).Conclusion serum miRNA-122 can be used as an indicator of non-invasive fibrosis in patients with hepatitis B,especially in patients with advanced fibrosis.
作者
郭萍
张军鹏
贺继东
GUO Ping;ZHANG Jun-peng;HE Ji-dong(Department of Gastroenterology,Baoji People's Hospital,Baoji 721000,Shanxi,China)
出处
《肝胆胰外科杂志》
CAS
2018年第4期298-302,共5页
Journal of Hepatopancreatobiliary Surgery