摘要
目的探讨血清可溶性P-选择素(sP-selectin)联合脑利钠肽(BNP)对乙型肝炎后肝硬化患者的预后价值。方法选取笔者医院2016年8月—2018年4月肝胆内科收治的111例乙型肝炎后肝硬化(其中42例转变为肝癌)患者,观察不同乙型肝炎后肝硬化程度及肝癌患者之间的血清sP-selectin、BNP的差异性,对乙型肝炎后肝硬化转变为肝癌行Logistic多因素回归分析单因素分析,以受试者工作特征曲线(ROC)分析血清sP-selectin、BNP对乙型肝炎后肝硬化转变为肝癌的预测价值。结果Child-Pugh A级乙型肝炎后肝硬化患者的血清sP-selectin、BNP水平显著低于B级与C级,B级乙型肝炎后肝硬化患者的血清sP-selectin、BNP水平显著低于C级,差异具有统计学意义(P<0.05)。原发性肝癌Ⅰ期患者血清sP-selectinBNP显著高于Ⅱ期患者,差异具有统计学意义(P<0.05)。Pearson分析显示,乙型肝炎后肝硬化和肝癌患者血清sP-selectin与BNP水平均呈正相关(r=0.401,r=0.476,且P<0.05)。血清sP-selectin、BNP是乙型肝炎后肝硬化患者进展成原发性肝癌的危险因素(P<0.05)。血清sP-selectin联合BNP的AUC为0.898高于独立检测。结论血清sP-selectin与BNP联合检测对乙型肝炎后肝硬化转变为原发性肝癌具有较高预测价值。
Objective To investigate the prognostic value of serum soluble P-selectin(sP-selectin)combined with brain natriuretic peptide(BNP)in patients with hepatitis B cirrhosis.Methods A total of 111 patients with hepatitis B cirrhosis(42 of them turned into liver cancer),admitted to our hospital from August 2016to April 2018were enrolled in this study.The differences in serum sP-selectin and BNP,among patients with different hepatitis B cirrhosis and liver cancerwere observed.Logistic multivariate regression analysis for single factor analysisonconversion from hepatitis B cirrhosisinto liver cancer wasperformed.The receiver operating characteristic curve(ROC)was used to analyze the predictivevalueof serum sP-selectin and BNP on conversion from hepatitis B cirrhosis into liver cancer.Results The levels of serum sP-selectin and BNP in patients with Child-Pugh grade A cirrhosis were significantly lower than those in grade B and C;while the levels of serum sP-selectin and BNP in patients with grade B cirrhosis were significantly lower than those with grade C(P<0.05).Serum sP-selectin and BNP in patients with stage I primary liver cancer were significantly higher than those with stage II(P<0.05).Upon pearson analysis,serum sP-selectin was positively correlated with BNP level in patients with hepatitis B cirrhosis and liver cancer(r=0.401,r=0.476,and P<0.05).Serum sP-selectin and BNPwererisk factors for progression of hepatitis B cirrhosis into primary liver cancer(P<0.05).The AUC of serum sP-selectin combined with BNP was 0.898,higher than that of independent dectection.Conclusion Serum sP-selectin and BNP are risk factors for the conversion of hepatitis B cirrhosis into primary liver cancer.The combined detection of the two indicators has a high predictivevalue for the conversion ofhepatitis B cirrhosis into primary liver cancer.
作者
陈鹤
CHEN He(Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300070,China)
出处
《实用医药杂志》
2020年第12期1067-1070,I0009,共5页
Practical Journal of Medicine & Pharmacy
