摘要
目的探讨慢性乙型肝炎(CHB)患者外周血自然杀伤细胞(NK)水平与肝纤维化的相关性,以指导未来CHB患者肝纤维化的风险评估与干预。方法选取2017年3月至2020年2月收治的83例CHB患者作为研究对象,检测患者的外周血NK细胞水平,根据Scheuer评分系统评估肝组织纤维化发生情况,将患者分为肝纤维化组(S1期~S4期)与对照组(S0期),比较两组外周血NK细胞水平,分析外周血NK细胞水平对CHB患者发生肝纤维化的影响与预测价值。结果本研究83例CHB患者,57例发生肝纤维化,肝纤维化发生率为68.67%(57/83)。对比肝纤维化组与对照组基线资料发现,两组性别、年龄、体质指数、病程、家族史、吸烟史、饮酒史比较,差异无统计学意义(P>0.05);肝纤维化组外周血NK细胞水平低于对照组,差异有统计学意义(P<0.05);经单项Logistic回归分析后建立多元回归模型行多因素分析,结果显示,外周血NK细胞低表达可能是CHB患者肝纤维化的影响因素(OR>1,P<0.05);绘制ROC曲线发现,外周血NK细胞水平预测CHB患者肝纤维化风险的AUC为0.842,有一定预测价值。结论外周血NK细胞低表达可能与CHB进程相关,影响肝纤维化发生,早期检测外周血NK细胞水平可预测CHB患者的肝纤维化风险并指导干预,可能对改善患者预后有积极意义。
Objective To investigate the correlation between the levels of natural killer cells(NK)in peripheral blood and liver fibrosis in chronic hepatitis B(CHB)patients,in order to provide guidance for the risk assessment and intervention of liver fibrosis.Methods A total of 83 CHB patients collected from March 2017 to February 2020 were studied.They were detected for their peripheral blood NK cell levels and evaluated the occurrence of histological liver fibrosis according to the Scheuer scoring system.The patients were divided into a liver fibrosis group(S1 stage-S4 stage)and a control group(S0 stage),Single and multi-factor logistic regression analyses were performed to analyze the influencing factors associated with liver fibrosis.Receiver operating characteristic curve(ROC)was drawn to evaluate the predictive value of peripheral blood NK cell level on liver fibrosis.Results Fifty-seven of the 83(68.67%)CHB patients had liver fibrosis.The baseline data of the liver fibrosis group and the control group including gender,age,body mass index,course of disease,family history,smoking history,and drinking history were not different(P>0.05).However,the level of peripheral blood NK cells in patients of the liver fibrosis group was significantly lower than that of the control group(P<0.05).Low expression of NK cells in peripheral blood was found to be an influencing factor associated with liver fibrosis(OR>1,P<0.05).The Area Under Curve(AUC)of peripheral blood NK cell level for predicting the risk of liver fibrosis in CHB patients was 0.842,which had certain predictive value.Conclusion Low expression of NK cells in peripheral blood may be related to the progression of CHB and affect the occurrence of liver fibrosis.Early detection of peripheral blood NK cell levels may have a positive significance for predicting the fibrosis risk and improving the prognosis of CHB patients after early intervention.
作者
李兰亚
伍广
屠涛
张丽
LI Lan-ya;WU Guang;TU Tao;ZHANG Li(Clinical Laboratory,Shuyang Hospital of traditional Chinese Medicine,Jiangsu 223600,China;Clinical Laboratory,Affiliated Hospital of Xuzhou Medical University,Jiangsu 221000,China)
出处
《肝脏》
2021年第8期879-882,共4页
Chinese Hepatology
