[1]阎冬梅,庞文艳,赵莲蕊.慢加急性肝衰竭患者血清Clusterin 和CCR5 表达水平及其对预后预测价值研究[J].现代检验医学杂志,2023,38(03):134-137+183.[doi:10.3969/j.issn.1671-7414.2023.03.024]
　YAN Dong-mei,PANG Wen-yan,ZHAO Lian-rui.Predictive Value of Combined Detection of Serum Clusterin and CCR5 Levels for Prognosis of Patients with Acute-on-Chronic Liver Failure[J].Journal of Modern Laboratory Medicine,2023,38(03):134-137+183.[doi:10.3969/j.issn.1671-7414.2023.03.024]
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慢加急性肝衰竭患者血清Clusterin 和CCR5 表达水平及其对预后预测价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年03期
页码:
134-137+183
栏目:
论著
出版日期:
2023-05-15

文章信息/Info

Title:
Predictive Value of Combined Detection of Serum Clusterin and CCR5 Levels for Prognosis of Patients with Acute-on-Chronic Liver Failure
文章编号:
1671-7414（2023）03-134-05
作者:
阎冬梅1; 庞文艳2; 赵莲蕊1
（1. 唐山市传染病医院，河北唐山 063000；2. 唐山市中心医院，河北唐山 063000）
Author(s):
YAN Dong-mei1;  PANG Wen-yan2;  ZHAO Lian-rui1
（1. Tangshan Infectious Diseases Hospital, Hebei Tangshan 063000, China；2. Tangshan Central Hospital, Hebei Tangshan 063000, China）
关键词:
丛生蛋白; 趋化因子受体5; 慢加急性肝衰竭
分类号:
R575.3；R392.11
DOI:
10.3969/j.issn.1671-7414.2023.03.024
文献标志码:
A
摘要:
目的 探讨血清丛生蛋白(Clusterin）及趋化因子受体5（CCR5）在慢加急性肝衰竭（acute-on-chronic liverfailure，ACLF）患者中的表达以及两者联合检测对ACLF 患者预后的预测价值。方法 选取2018 年1 月～ 2020 年12月唐山市传染病医院收治的84 例ACLF 患者作为观察组，同期选择在该院体检的80 例健康体检者作为对照组。采用酶联免疫吸附试验(ELISA）法测定患者血清中Clusterin 和CCR5 水平；根据患者预后28 天情况，将其分为存活组（n=48）和死亡组（n=36）。采用受试者工作特征曲线（receiver operating characteristic curve，ROC）分析血清Clusterin 与CCR5联合检测对ACLF患者预后的预测价值；Spearman 相关性分析血清Clusterin 和CCR5水平与终末期肝病模型(modelfor end-stage liver disease，MELD) 评分、慢性肝衰竭- 序贯器官衰竭评分(chronic liver failure-sequential organ failureassessment，CLIF-SOFA) 的相关性；采用多因素Logistic 回归分析ACLF 患者预后的影响因素。结果 与对照组相比，观察组Clusterin（87.37±9.99μg/ml vs 104.85±15.14μg/ml） 及CCR5（11.55±2.86μg/ml vs 15.68±3.01μg/ml） 水平降低，差异具有统计学意义（t=8.767，9.010，均P<0.05）。与存活组相比，死亡组Clusterin（77.40±9.26μg/ml vs94.85±10.54μg/ml）及CCR5（8.58±1.98μg/ml vs 13.78±3.52μg/ml）水平降低，差异具有统计学意义（t=7.904，7.962，均P<0.05）。ROC 曲线显示，血清Clusterin 与CCR5 联合预测的曲线下面积（area under curve，AUC）（0.927）最大，其敏感度和特异度分别为88.90% 和83.30%。经Spearman 相关性分析Clusterin 与MELD，CLIF-SOFA 评分呈负相关（r=-0.524，-0.457，均P<0.05），CCR5 与MELD，CLIF-SOFA 评分呈负相关（r=-0.611，-0.358，均P<0.05）。多因素Logistic 回归分析显示，血清Clusterin，CCR5 及IL-6 为ACLF 患者预后不良的影响因素（均P ＜ 0.05）。结论 Clusterin 及CCR5 在ACLF 患者血清中表达下调，且联合检测二者在预测ACLF 患者短期预后方面具有良好的参考价值。
Abstract:
Objective To investigate the expression levels of serum Clusterin and C-C chemokine receptor 5 (CCR5) in patients with acute-on-chronic liver failure (ACLF) and the predictive value of their combined detection for the prognosis of ACLF patients. Methods A total of 84 ACLF patients admitted to Tangshan Infectious Disease Hospital from January 2018 to December 2020 were taken as the observation group, and 80 healthy subjects in the hospital were taken as the control group. The levels of Clusterin and CCR5 in serum of patients were determined by enzyme-linked immunosorbent assay (ELISA). According to the 28-day prognosis of patients, they were grouped into a survival group (n=48) and a death group (n=36). Receiver operating characteristic (ROC) curve was applied to analyze the predictive value of serum Clusterin and CCR5 combined detection on the prognosis of ACLF patients. Spearman correlation was applied to analyze the correlation between serum Clusterin and CCR5 levels, model of end-stage liver disease (MELD) score and chronic liver failure-sequential organ failure assessment (CLIF-SOFA) score. Multivariate Logistic regression was applied to analyze the prognostic factors of ACLF patients. Results Compared with the control group, the levels of Clusterin(87.37±9.99μg/ml vs 104.85±15.14μg/ml) and CCR5 (11.55±2.86μg/ml vs15.68±3.01μg/ml) in the observation group were lower, and the differences were statistically significant (t=8.767, 9.010, all P<0.05).Compared with the survival group, the Clusterin (77.40±9.26μg/ml vs 94.85±10.54μg/ml) and CCR5 (8.58±1.98μg/ml vs 13.78±3.52μg/ml) levels in the death group were lower (t=7.904, 7.962, all P<0.05). The ROC curve showed that the area under the curve (0.927) of the combined prediction of serum Clusterin and CCR5 was the largest, and the sensitivity and specificity were 88.90% and 83.30%, respectively .The Spearman correlation analysis showed that Clusterin was negatively correlated with MELD and CLIF-SOFA scores (r=-0.524, -0.457, all P<0.05), and CCR5 was negatively correlated with MELD and CLIF-SOFA scores (r=-0.611, -0.358, all P<0.05). Multivariate Logistic regression analysis showed that serum Clusterin ,CCR5 and IL-6were the influencing factors of poor prognosis in ACLF patients (all P<0.05). Conclusion The expressions of Clusterin and CCR5 were down-regulated in the serum of ACLF patients, and the combined detection of the two has a good reference value in predicting the short-term prognosis of ACLF patients.

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备注/Memo

备注/Memo:
基金项目：2020 年河北省医学科学研究课题计划项目（编号：20201438）：人工肝血浆置换治疗肝衰竭的疗效及成本效果分析。
作者简介： 阎冬梅（1975-），本科，女，主治医师，研究方向：人工肝血浆置换治疗肝衰竭疗效及成本及效果分析，E-mail：yandongmei1975@163.com。
通讯作者： 赵莲蕊（1971-），女，硕士，副主任医师，研究方向：人工肝血浆置换治疗肝衰竭疗效及效果分析，E-mail：buyf92@163.com。
更新日期/Last Update: 2023-05-15