[1]郭 堑,农村立,韦秋芳.慢性乙型肝炎肝纤维化患者血清Copeptin 和PCT 表达水平及其临床价值研究[J].现代检验医学杂志,2023,38(02):112-117+189.[doi:10.3969/j.issn.1671-7414.2023.02.021 ]
 GUO Qian,NONG Cun-li,WEI Qiu-fang.Serum Copeptin and PCT Expression Levels and Their Diagnostic Value in Patients with Hepatitis B Liver fibrosis[J].Journal of Modern Laboratory Medicine,2023,38(02):112-117+189.[doi:10.3969/j.issn.1671-7414.2023.02.021 ]
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慢性乙型肝炎肝纤维化患者血清Copeptin 和PCT 表达水平及其临床价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年02期
页码:
112-117+189
栏目:
论著
出版日期:
2023-03-15

文章信息/Info

Title:
Serum Copeptin and PCT Expression Levels and Their Diagnostic Value in Patients with Hepatitis B Liver fibrosis
文章编号:
1671-7414(2023)02-112-07
作者:
郭 堑农村立韦秋芳
(广西医科大学第四附属医院 /柳州市工人医院感染性疾病科,广西柳州 545005)
Author(s):
GUO QianNONG Cun-liWEI Qiu-fang
(Department of Infectious Diseases, the Fourth Affiliated Hospital of Guangxi Medical University/Liuzhou Workers Hospital, Guangxi Liuzhou 545005, China)
关键词:
慢性乙型肝炎肝纤维化和肽素降钙素原
分类号:
R575.2;R392.11
DOI:
10.3969/j.issn.1671-7414.2023.02.021
文献标志码:
A
摘要:
目的 探讨慢性乙型肝炎肝纤维化患者血清和肽素(Copeptin)和降钙素原(procalcitonin ,PCT)表达水平,并分析其在肝纤维化诊断中的价值。方法 共纳入 2019年 2月 ~2021年 12月在广西医科大学第四附属医院就诊的 195例慢性肝病单感染 HBV患者作为 HBV组,并选择同一期间在该院进行健康体检的志愿者作为对照组。其中 HBV组中慢性乙型肝炎(CHB)患者 117例(CHB组), CHB相关肝硬化(LC)患者 78例(LC组),对所有参与患者进行临床指标分析,采用 ELISA方法检测患者血清 Copeptin和 PCT表达水平。METAVIR评分系统评估 CHB组中接受肝活检的患者的肝纤维化程度; Child-Pugh分级评估 LC患者的肝功能障碍程度。比较 Copeptin,PCT表达水平与肝纤维化和肝功能的关系。 ROC曲线评估肝纤维化诊断生物标志物。结果 HBV组血清 Copeptin(2.39±0.73 ng/ml vs 1.19±0.39 ng/ml)和 PCT(2.11±0.69 ng/ml vs 0.97±0.31 ng/ml)水平明显高于对照组(t=11.912,12.108,均 P <0.05),并且与 CHB组比较, LC组血清 Copeptin(3.18±0.96 ng/ml vs 1.87±0.58 ng/ml)和 PCT(2.87±0.92 ng/ml vs 1.61±0.53 ng/ ml)表达水平增加(t=11.871,12.111,均 P<0.05),差异具有统计学意义。血清 Copeptin和 PCT表达水平随着肝纤维化程度和 Child-Pugh分级的增加而升高,差异有统计学意义(t=2.887~9.116,均 P <0.05)。血清 Copeptin和 PCT表达水平及其他无创方法 [肝脏硬度(LSM),AST与血小板比率指数(APRI)和纤维化 -4(fiB-4)指数 ]区分 CHB患者发生 F0~F1期与 F2~F3期肝纤维化的 ROC曲线下面积分别为 0.910,0.889,0.790,0.765和 0.672,而以上五项指标联合的曲线下面积为 0.962。Copeptin和 PCT区分 CHB患者肝纤维化程度的曲线下面积及总有效率高于肝纤维化指标(IV型胶原、III型前胶原、透明质酸酶、层黏连蛋白)。结论 血清 Copeptin和 PCT在慢性乙型肝炎肝纤维化患者中高表达,能够用于诊断肝纤维化程度。
Abstract:
Objective To determine the expression characteristics of serum Copeptin and procalcitonin (PCT) in patients with hepatitis B virus (HBV), and analyze their diagnostic value in liver fibrosis. Methods A total of 195 patients with chronic liver disease single-infected with HBV who were treated in the Fourth Affiliated Hospital of Guangxi Medical University from February 2019 to December 2021 were included as the HBV group, and volunteers who underwent physical examination in the hospital during the same period were selected as the control group. Among them, there were 117 patients with chronic hepatitis B (CHB) in the HBV group (CHB group), and 78 patients with CHB-related liver cirrhosis (LC) (LC group). The clinical indicators of all the participating patients were analyzed, and the serum Copeptin and PCT expression levels of the patients in each group were detected by ELISA. The METAVIR scoring system assessed the degree of liver fibrosis in patients in the CHB group who underwent liver biopsy. The Child-Pugh classification assessed the degree of liver dysfunction in patients with LC. The relationship between Copeptin and PCT expression levels and liver fibrosis and liver function were compared, and ROC curve evaluation of diagnostic biomarkers of liver fibrosis. Results The levels of serum Copeptin (2.39±0.73 ng/ml vs 1.19±0.39 ng/ml) and PCT (2.11±0.69 ng/ml vs 0.97±0.31 ng/ml) in the HBV group were significantly higher than those in the control group (t=11.912, 12.108, all P <0.05), and compared with the CHB group, the expression levels of serum Copeptin and PCT in the LC group increased (3.18±0.96 ng/ml vs 1.87±0.58 ng/ml, 2.87±0.92 ng/ml vs 1.61±0.53 ng/ml, t=11.871, 12.111, all P<0.05), and the difference were statistically significant. Serum Copeptin and PCT expression levels increased with the degree of liver fibrosis and Child-Pugh grade (t=3.666, 2.887, 9.116, 3.755, all P <0.05). Serum Copeptin, PCT expression levels and other non-invasive methods [liver stiffness (LSM), AST to platelet ratio index (APRI) and fibrosis-4 (fiB-4) index] to differentiate CHB patients with F0~F1 and F2~F3 stages the areas under the ROC curve of liver fibrosis were 0.910, 0.889, 0.790, 0.765 and 0.672, respectively, and the combined area under the curve of the above five indicators was 0.962. The area under the curve and total effective rate of Copeptin and PCT in differentiating the degree of liver fibrosis in CHB patients were higher than those of liver fibrosis indicators (type IV collagen, type III procollagen, hyaluronidase, laminin). Conclusion Serum Copeptin and PCT were highly expressed in patients with chronic hepatitis B liver fibrosis and can be used to diagnose the degree of liver fibrosis.

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备注/Memo

备注/Memo:
收稿日期:2022-06-13修回日期:2022-10-27
基金项目:广西科技计划项目(编号:桂科 AB18050020):肝细胞癌遗传靶标筛选与鉴定及风险评估模型的建立。
作者简介:郭堑(1970-),女,本科,主任医师,主要从事各类肝病、感染方面研究, E-mail:guoqian58200@163.com。

更新日期/Last Update: 2023-03-15