摘要
目的:探讨生长分化因子15(growth differentiation factor 15,GDF-15)检测对预测慢性肝脏疾病严重程度的临床应用价值。方法:通过酶联免疫吸附测定法对100例慢性肝病患者和100名健康人进行血清GDF-15水平检测。100例慢性肝病患者包括慢性肝炎患者35例、肝硬化代偿期患者32例和肝硬化失代偿期患者33例;比较不同阶段慢性肝病患者丙氨酸转氨酶(alamine aminotransferase,ALT)、天冬氨酸转氨酶(aspartate aminotransferase,AST)、总胆红素(total bilirubin,TBIL)、GDF-15及国际标准化比值(international normalized ratio,INR)水平;采用Pearson相关性检验分析GDF-15水平与肝硬化判别式值(cirrhosis discriminant score,CDS)、Child-Pugh及终末期肝病模型(model for end-stage liver disease,MELD)评分关系。采用受试者工作特征曲线(receiver operator characteristic curve,ROC曲线)分析血清GDF-1水平对慢性肝病严重程度的预测价值。结果:肝硬化失代偿期患者[(3 485±658)ng/L]血清GDF-15水平高于肝硬化代偿期[(1 864±254)ng/L]和慢性肝炎[(1 234±242)ng/L]患者;Spearman相关分析结果显示血清GDF-15与CDS、Child-Pugh及MELD评分均呈正相关(均P<0.01);血清GDF-15水平在慢性肝炎、肝硬化代偿期和肝硬化失代偿期的ROC曲线下面积分别为0.719、0.806和0.839。结论:血清GDF-15水平可作为一个有效的生物标志物,用于评估肝脏纤维化和慢性肝病的严重程度。
objective To explore the performances of growth differentiation factor 15(GDF-15)testing in assessing the liver fibrosis and severity of chronic liver diseases.Methods The serum GDF-15 levels were examined by enzyme-linked immunosorbent assay in 100 patients with chronic liver diseases,including 35 with chronic hepatitis,32 with compensated liver cirrhosis,and 33 with decompensated liver cirrhosis,and 100 healthy individuals.The receiver operator characteristic curve(ROC curve)was used to evaluate the performance of GDF-15,aspartate aminotransferase(AST)and alamine amino-transferase(ALT)test in staging the severity of chronic liver diseases.Pearson correlation analysis was performed to test the correlation of GDF-15 with cirrhosis discriminant score(CDS),Child-Pugh and model for end-stage liver disease(MELD)score.Results Of the patients with chronic liver diseases,serum GDF-15(3 485±658)ng/L levels was higher in patients with decompensated liver cirrhosis than the patients with compensated liver cirrhosis(1 864±254)ng/L and chronic hepatitis(1 234±242)ng/L.Spearman correlation analysis showed that the GDF-15 level in peripheral blood was positive correlated with CDS,Child-Pugh and MELD.The overall diagnostic accuracies of GDF-15,as determined by the area under the ROC curves,were as follows:chronic hepatitis 0.719,compensated liver cirrhosis 0.806,and decompensated liver cirrhosis 0.839,respectively.Conclusions GDF-15 level was a useful biomarker for the prediction of liver fibrosis and assessment of chronic liver disease severity.
作者
王运东
张运东
王立志
WANG Yundong;ZHANG Yundong;WANG Lizhi(Department of Infection,Ezhou Centred Hospital,Ezhou436000,China)
出处
《内科理论与实践》
2019年第3期183-187,共5页
Journal of Internal Medicine Concepts & Practice
基金
湖北省教育厅科研项目(项目编号:B2017167)
关键词
慢性肝病
生长分化因子15
肝硬化
肝脏纤维化
Chronic liver disease
Growth differentiation factor 15
Liver cirrhosis
Liver fibrosis
