摘要
目的分析血T细胞免疫球蛋白黏蛋白3(Tim-3)联合[γ-谷氨酰转肽酶(γ-GT)/胆碱酯酶(CHE)](GCR)比值在转氨酶正常或轻度升高慢性乙型肝炎患者中的临床价值。方法选取109例转氨酶正常或轻度升高慢性乙型肝炎患者临床资料进行回顾性分析,绘制受试特征者工作(ROC)曲线探讨血Tim-3和GCR在转氨酶正常或轻度升高慢性乙型肝炎患者肝脏炎症分期和肝纤维化分级中的价值。结果109例CHB患者中,G140例、G230例、G326例、G413例;S144例、S232例、S320例、S413例。CHB患者肝脏炎症不同分期血Tim-3和GCR比较,差异有统计学意义(F=24.581,P=0.002;F=12.495,P=0.013);其中G2期患者血Tim-3为(16.09±3.57)ng/L,GCR为(1.04±0.29),高于G1期患者的(14.28±2.43)ng/L和(0.86±0.17),G3期患者血Tim-3为(18.65±4.81)ng/L,GCR为(1.26±0.38),高于G2期患者(P<0.05),G4期患者血Tim-3为(21.14±5.92)ng/L,GCR为(1.41±0.47),高于G3期患者(P<0.05);绘制ROC曲线分析发现,Tim-3和GCR均可预测肝脏炎症(≥G2)、(≥G3)和(G4)(P<0.05),但以Tim-3和GCR联合曲线下面积(AUC)最大(P<0.05)。CHB患者肝脏纤维化不同分期血Tim-3和GCR比较,差异有统计学意义(F=22.165,P=0.008;F=11.388,P=0.018);其中S2期患者血Tim-3和GCR高于S1期患者(P<0.05),S3期患者血Tim-3和GCR高于S2期患者(P<0.05),S4期患者血Tim-3和GCR高于S3期患者(P<0.05);绘制ROC曲线分析发现,Tim-3和GCR均可预测肝脏炎症(≥S2)、(≥S3)和(S4)(P<0.05),但以Tim-3和GCR联合曲线下面积(AUC)最大(P<0.05)。结论TIM-3和GCR均可预测转氨酶正常或轻度升高慢性乙型肝炎肝脏炎症和肝纤维化不同分期患者,尤以两者联合效能最高。
Objective To investigate the clinical value of T cell immunoglobulin mucin 3(Tim-3)combined with gamma-glutamyl transpeptidase to cholinesterase ratio(GCR)in chronic hepatitis B(CHB)patients with normal or slightly elevated transaminase.Methods The clinical data of 109 CHB patients with normal or slightly elevated transaminase were retrospectively analyzed.The receiver operating characteristic(ROC)curve was used to analyze the value of serum Tim-3 and GCR in evaluating the liver inflammation stage and liver fibrosis grade of CHB patients with normal or slightly elevated transaminase.Results Among 109 CHB patients,the numbers of inflammation stages 1,2,3 and 4 were 40,30,26 and 13;the numbers of fibrosis stages 1,2,3,and 4 were 44,32,20 and 13.The serum Tim-3 level and GCR in CHB patients with different liver inflammation stages were significantly different(F=24.581,P=0.002;F=12.495,P=0.013).The serum Tim-3 level and GCR of patients in G2[(16.09±3.57)ng/L,(1.04±0.29)]were higher than those of patients in G1[(14.28±2.43)ng/L,(0.86±0.17)]and lower than those of patients in G3[(18.65±4.81)ng/L,(1.26±0.38)ng/L],(P<0.05).The serum Tim-3 level and GCR of patients in G4[(21.14±5.92)ng/L,(1.41±0.47)ng/L]were higher than those of patients in G3[(18.65±4.81)ng/L,(1.26±0.38)ng/L],(P<0.05).ROC curve analysis showed that both Tim-3 and GCR could predict liver inflammation stages.The area under the curve(AUC)of Tim-3 combined with GCR was the largest(P<0.05).The serum Tim-3 level and GCR of CHB patients with different liver fibrosis stages were significantly different(F=22.165,P=0.008;F=11.388,P=0.018).The serum Tim-3 level and GCR of patients in S2 were higher than those of patients in S1(P<0.05)and lower than those of patients in S3(P<0.05).The serum Tim-3 level and GCR of patients in S4 were higher than those of patients in S3(P<0.05).ROC curve analysis showed that both Tim-3 and GCR can predict liver fibrosis stages(P<0.05).The AUC of Tim-3 combined with GCR was the largest(P<0.05).Conclusion Both Tim-3 and GCR ca
作者
黎妮
黄裕林
马世河
LI Ni;HUANG Yu-lin;MA Shi-he(Clinical Laboratory,Kaizhou District People′s Hospital,Chongqing 405400,China)
出处
《肝脏》
2022年第1期42-46,共5页
Chinese Hepatology
基金
重庆市开州区2018年第四批科技指导性计划项目(开科发[2018]16号)。
关键词
慢性乙型肝炎
转氨酶
T细胞免疫球蛋白黏蛋白3
Γ-谷氨酰转肽酶
胆碱酯酶
肝脏炎症
肝纤维化
Chronic hepatitis B
Normal or slightly elevated transaminase
T cell immunoglobulin mucin 3
Gamma-glutamyl transpeptidase
Cholinesterase
Liver inflammation
Liver fibrosis
