摘要
目的探讨血清壳多糖酶3样蛋白1(CHI3L1)与透明质酸(HA)、Ⅲ型前胶原(PⅢNP)、层粘连蛋白(LN)、Ⅳ型胶原(CⅣ)和纤维连接蛋白(FN)水平(以下简称“肝纤五项”)在乙型肝炎病毒相关肝硬化中的诊断价值。方法将湖南省人民医院2016年6月至2017年6月住院的慢性乙肝患者62例、肝硬化患者28例、原发性肝癌患者21例纳入研究(均为乙肝表面抗原阳性)。选取同期在该院进行体检且各项指标未见异常者30例作为对照组。用酶联免疫吸附测定检测血清CHI3L1水平,用化学发光法检测血清肝纤五项水平。结果不同组别间CHI3L1和肝纤五项水平比较差异均有统计学意义(P<0.05)。肝硬化组的CHI3L1水平明显高于原发性肝癌组、慢性乙肝组和对照组(P<0.05)。肝硬化组的肝纤五项部分项目水平明显高于慢性乙肝组和对照组(P<0.05)。logistic回归模型显示,CHI3L1、LN和CⅣ纳入模型。ROC曲线分析显示,CHI3L1、LN和CⅣ用于区分非肝硬化和肝硬化患者的曲线下面积分别为0.799、0.794和0.888,以CHI3L1:215.34pg/mL、LN:124.01ng/mL和CⅣ:84.27ng/mL为诊断界值点时,敏感度分别为82.1%、71.4%和92.9%,特异度分别为69.0%、84.1%、76.1%。CHI3L1、LN和CⅣ联合检测时,敏感度和特异度分别提高至82.1%和85.8%。结论血清CHI3L1、LN和CⅣ水平对肝硬化的诊断有一定价值;血清CHI3L1、LN和CⅣ联合检测可提高对肝硬化的诊断效能。
Objective To investigate the diagnostic value of chitinase 3-like 1(CHI3L1),hyaluronate(HA),procollagenⅢN-terminal peptide(PⅢNP),laminin(LN),collegen typeⅣ(CⅣ)and fibronectin(FN)in liver cirrhosis caused by hepatitis B virus.Methods There were four groups:chronic hepatitis B group(62 cases),cirrhosis group(28 cases),liver cancer group(21 cases),and healthy control group(30 cases).Except the healthy control group,the patients were positive for hepatitis B virus.The serum level of CHI3L1 was detected by enzyme linked immunosorbent assay(ELISA),and the serum levels of HA,LN,CⅣ,PⅢNP and FN were detected by chemiluminescent immunoassay.Results The levels of serum CHI3L1,HA,LN,CⅣ,PⅢNP and FN were significantly different in four groups(P<0.05).The levels of part items in CHI3L1,HA,LN,CⅣ,PⅢNP and FN were higher in liver cirrhosis group than those in control group,chronic hepatitis B group and liver cancer group(P<0.05).The area under curve(AUC)for CHI3L1,LN and CⅣin distinguishing liver cirrhosis were 0.799,0.794,0.888.When CHI3L1:215.34 pg/mL,LN:124.01 ng/mL and C IV:84.27 ng/mL were used as diagnostic thresholds,sensitivity and specificity of CHI3L1,LN and CⅣwere 82.1%,71.4%,92.9%and 69.0%,84.1%,76.1%respectively.When CHI3L1,LN and CIV were combined,the sensitivity and specificity increased to 82.1%and 85.8%respectively.Conclusion Serum CHI3L1,LN and CⅣlevel are valuable in the diagnosis of liver cirrhosis.The combined detection of serum CHI3L1,LN and CⅣcan improve the diagnostic efficacy of liver cirrhosis.
作者
黎村艳
段贞
朱雅祺
张柏银
曹友德
谭黎明
钟婕
周兵飞
LI Cunyan;DUAN Zhen;ZHU Yaqi;ZHANG Baiyin;CAO Youde;TAN Liming;ZHONG Jie;ZHOU Bingfei(Department of Clinical Laboratory,Hunan Provincial People′s Hospital/The first affiliated hospital of Hunan Normal Uiversity,Changsha,Hunan 410005,China;Research Section,Hunan Provincial People′s Hospital/The first affiliated hospital of Hunan Normal Uiversity,Changsha,Hunan 410005,China;Hunan Normal University School of Medicine,Changsha,Hunan 410006,China;Department of Anesthesiology,Hunan Brain Hospital,Changsha,Hunan 410005,China)
出处
《国际检验医学杂志》
CAS
2019年第15期1807-1810,共4页
International Journal of Laboratory Medicine
基金
湖南省科技厅技术创新引导计划临床医疗技术创新引导项目(2017TT96)
湖南省中医药科研计划项目(201635)
