摘要
目的:探讨肠道菌群参数联合维生素D在肝纤维化诊断和病情评估中的价值.方法:选我院2020年1月~2022年12月98例肝炎者,统计对比纤维化与无纤维化患者肠道菌群参数与血清25-羟维生素D3(25-hydroxyvitamin D3,25-(OH)D3)水平,分析肠道菌群参数联合25-(OH)D3在肝纤维化诊断与病情评估中价值.结果:纤维化患者双歧杆菌、血清25-(OH)D3水平低于无纤维化患者,肠杆菌、肠球菌高于无纤维化患者(P<0.05);受试者工作特征(Receiver operating characteristic curve,ROC)曲线显示,肠杆菌、肠球菌、双歧杆菌、25-(OH)D3联合应用诊断肝纤维化的AUC为0.820,最佳敏感度与特异度分别为88.61%、82.35%(P<0.05);高水平双歧杆菌、肠杆菌、肠球菌以及血清25-(OH)D3水平肝炎患者发生肝纤维化的危险度为低水平者的0.426倍、1.974倍、2.123倍、0.375倍(P<0.05);不同肝纤维化程度双歧杆菌、血清25-(OH)D3水平对比:S0期>S1期>S2期>S3期>S4期,不同肝纤维化程度的肠杆菌、肠球菌对比,S0期<S1期<S2期<S3期<S4期(P<0.05);双歧杆菌、25-(OH)D3和肝纤维化分期成反比,肠杆菌、肠球菌和肝纤维化分期成正比(P<0.05).结论:肠道菌群参数与血清25-(OH)D3水平联合应用于肝纤维化诊断中,诊断效能高,并能反映病情程度,可为临床早期诊疗提供依据.
Objective:To investigate the value of intestinal flora parameters combined with vitamin D in the diagnosis and assessment of hepatic fibrosis.Methods:From January 2020 to December 2022,98 hepatitis patients in our hospital were selected to statistically compare Gut microbiota parameters and serum 25 hydroxyvitamin D3(25 hydroxyvitamin D3,25-(OH)D3)levels in patients with and without fibrosis,and analyze the value of Gut microbiota parameters combined with 25-(OH)D3 in the diagnosis and assessment of liver fibrosis.Results:The levels of bifidobacteria and serum 25-(OH)D3 in patients with fibrosis were lower than those in patients without fibrosis,and the levels of Enterobacteriaceae and Enterococcus were higher than those in patients without fibrosis(P<0.05);The receiver operating characteristic curve(ROC)curve showed that the AUC of enterobacter,Enterococcus,bifidobacteria and 25-(OH)D3 in the diagnosis of liver fibrosis was 0.820,and the best sensitivity and specificity were 88.61%and 82.35%,respectively(P<0.05);The risk of liver fibrosis in hepatitis patients with high levels of bifidobacteria,enterobacteria,Enterococcus and serum 25-(OH)D3 was 0.426 times,1.974 times,2.123 times and 0.375 times higher than those with low levels(P<0.05);Comparison of bifidobacteria and serum 25-(OH)D3 levels in different degrees of liver fibrosis:S0>S1>S2>S3>S4;comparison of enterobacteria and Enterococcus in different degrees of liver fibrosis:S0<S1<S2<S3<S4(P<0.05);Bifidobacterium,25-(OH)D3 were inversely proportional to the stage of liver fibrosis,while Enterobacteriaceae,Enterococcus were inversely proportional to the stage of liver fibrosis(P<0.05).Conclusion:The combined application of intestinal flora parameters and serum 25-(OH)D3 level in the diagnosis of hepatic fibrosis has high diagnostic efficacy and can reflect the severity of the disease,which can provide the basis for early clinical diagnosis and treatment.
作者
彭慧斌
朱卫伟
侯永杰
Peng Hui-bin;Zhu Wei-wei;Hou Yong-jie(Department of Pathology,Anyang Cancer Hospital,Anyang 455000,Henan,China)
出处
《四川生理科学杂志》
2024年第3期500-503,共4页
Sichuan Journal of Physiological Sciences
基金
河南省科技攻关项目(编号:212102310718)。
