Tumor necrosis factor -a (TNF- a)was consideral to be a key mediator in the pathogenesis of endotoxin hepatoxicity. However, the precise mechanism by which TNF- a mediate liver injury remains un certain. Many results ...Tumor necrosis factor -a (TNF- a)was consideral to be a key mediator in the pathogenesis of endotoxin hepatoxicity. However, the precise mechanism by which TNF- a mediate liver injury remains un certain. Many results have shown that TNF - a could mediate neutrophil adherence, activate phospholipase A2, induce Pedction of lipid ndators, fine radicals and so on, all of which played fort role in development of liver injury. This article reviewed recent infonnations about cytotoxic mechanism of TNF -展开更多
目的探讨alanine-aminotransferase to platelet ratio index(APRI)、gamma-glutamyl transpeptidase to platelet ratio index(GPRI)、fibrosis 4 score(FIB-4)三种模型在诊断慢性乙型肝炎(chronic hepatitis B,CHB)所致肝纤维化及肝...目的探讨alanine-aminotransferase to platelet ratio index(APRI)、gamma-glutamyl transpeptidase to platelet ratio index(GPRI)、fibrosis 4 score(FIB-4)三种模型在诊断慢性乙型肝炎(chronic hepatitis B,CHB)所致肝纤维化及肝癌中的临床应用价值。方法选取于山西医科大学第一医院2014-03~2017-08曾接受过肝组织穿刺活检或曾行肝脏切除有肝组织病理检查结果的63例CHB患者为研究对象,收集符合条件患者的相关病例资料,以病理结果为标准,将研究对象分为轻度肝纤维化组(S0-1)、中度肝纤维化组(S2-3)、肝硬化组(S4)、肝癌组。计算各组患者的APRI、GPRI、FIB-4值。对APRI、GPRI、FIB-4三种无创诊断模型与肝组织病理结果的相关性检验采用Spearman相关分析,应用受试者工作特征曲线(ROC)分析方法计算曲线下面积(AUC),以评价三种模型对各分组的诊断效能,并确定诊断的最佳截断值、敏感度和特异度。采用Logistic回归分析构建联合预测因子,并采取AUC评价三种模型联合对肝纤维化及肝癌诊断的准确性。结果 APRI、FIB-4、GPRI值与肝纤维化分期及肝癌间均有良好的相关性,相关系数r分别为0.612,0.751,0.469,均P<0.05。APRI、GPRI、FIB-4均对肝硬化组(S4)及肝癌组有较好的诊断效能,而三种模型联合时,对轻度肝纤维化组(S0-S1)、明显肝纤维化组(S2-S3)、肝硬化组(S4)、肝癌组的诊断效能均有所提高。结论 APRI、GPRI、FIB-4指标联合对肝纤维化及肝癌的诊断与病理诊断价值趋近,且对肝纤维化的早期诊断、早期治疗有较高的指导价值。展开更多
文摘Tumor necrosis factor -a (TNF- a)was consideral to be a key mediator in the pathogenesis of endotoxin hepatoxicity. However, the precise mechanism by which TNF- a mediate liver injury remains un certain. Many results have shown that TNF - a could mediate neutrophil adherence, activate phospholipase A2, induce Pedction of lipid ndators, fine radicals and so on, all of which played fort role in development of liver injury. This article reviewed recent infonnations about cytotoxic mechanism of TNF -
文摘目的探讨alanine-aminotransferase to platelet ratio index(APRI)、gamma-glutamyl transpeptidase to platelet ratio index(GPRI)、fibrosis 4 score(FIB-4)三种模型在诊断慢性乙型肝炎(chronic hepatitis B,CHB)所致肝纤维化及肝癌中的临床应用价值。方法选取于山西医科大学第一医院2014-03~2017-08曾接受过肝组织穿刺活检或曾行肝脏切除有肝组织病理检查结果的63例CHB患者为研究对象,收集符合条件患者的相关病例资料,以病理结果为标准,将研究对象分为轻度肝纤维化组(S0-1)、中度肝纤维化组(S2-3)、肝硬化组(S4)、肝癌组。计算各组患者的APRI、GPRI、FIB-4值。对APRI、GPRI、FIB-4三种无创诊断模型与肝组织病理结果的相关性检验采用Spearman相关分析,应用受试者工作特征曲线(ROC)分析方法计算曲线下面积(AUC),以评价三种模型对各分组的诊断效能,并确定诊断的最佳截断值、敏感度和特异度。采用Logistic回归分析构建联合预测因子,并采取AUC评价三种模型联合对肝纤维化及肝癌诊断的准确性。结果 APRI、FIB-4、GPRI值与肝纤维化分期及肝癌间均有良好的相关性,相关系数r分别为0.612,0.751,0.469,均P<0.05。APRI、GPRI、FIB-4均对肝硬化组(S4)及肝癌组有较好的诊断效能,而三种模型联合时,对轻度肝纤维化组(S0-S1)、明显肝纤维化组(S2-S3)、肝硬化组(S4)、肝癌组的诊断效能均有所提高。结论 APRI、GPRI、FIB-4指标联合对肝纤维化及肝癌的诊断与病理诊断价值趋近,且对肝纤维化的早期诊断、早期治疗有较高的指导价值。
