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血清高尔基体蛋白73在辅助诊断慢性乙型肝炎患者中度以上肝损伤中的应用
Value of serum Golgi protein 73 in assisting the diagnosis of moderate or severe liver injury in patients with chronic hepatitis B
文章发布日期:2018年03月07日  来源:  作者:姚明解,王雷婕,关贵文,等  点击次数:665次  下载次数:69次

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【摘要】:目的评价血清标志物高尔基体蛋白73(GP73)对慢性乙型肝炎患者肝组织炎症活动度与纤维化程度的诊断价值。方法回顾性收集2013年12月-2017年5月就诊于中国人民解放军第三〇二医院行肝穿刺检查的678例慢性乙型肝炎患者的血清,并随机分为2组(A组477例,B组201例),使用ELISA试剂盒,依照说明书进行血清GP73的定量检测。2独立样本间比较采用Mann-Whitny U检验,相关性比较使用Spearman 相关性分析,定性资料组间比较采用χ2检验。结果血清GP73在A组与B组患者中均随着肝组织炎症活动度与纤维化程度的加重而升高,在A组患者中血清GP73与肝脏炎症活动度及纤维化程度均显著相关(r值分别为0.529、0.434,P值均<0.001),在B组患者中也得到了类似的结果(r值分别为0.418、0.437,P值均<0.001)。血清GP73诊断肝脏中度及以上炎症坏死(G≥2)及重度及以上炎症坏死(G≥3)的受试者工作特征曲线下面积,A组患者分别为0774[95%可信区间(95%CI):0.733~0.811,P<0.001)和0.844(95%CI:0.808~0875,P<0.001),B组患者分别为0.730(95%CI:0.663~0.790,P<0.001)和0.716(95%CI:0.649~0.777,P<0.001)。ALT联合血清GP73检测在A组中可以使77.4%的G≥2和(或)S≥2患者被鉴别出来,B组中78.9%的患者被鉴别出来。结论血清GP73可用于辅助ALT鉴别适宜抗病毒治疗的慢性乙型肝炎患者,减少对肝穿刺活组织检查的依赖。
【Abstract】:ObjectiveTo investigate the value of Golgi protein 73 (GP73) in the diagnosis of liver inflammatory activity and fibrosis degree in chronic hepatitis B (CHB) patients. MethodsSerum samples were collected from 678 patients who underwent liver biopsy in 302 Hospital of PLA from December 2013 to May 2017, and the patients were randomly divided into group A with 477 patients and group B with 201 patients. A double-antibody sandwich ELISA kit was used to measure the serum level of GP73 according to instructions. The Mann-Whitney U test was used for the comparison of two independent samples, the Spearman correlation analysis was used to investigate correlation, and the chi-square test was used for comparison of categorical data between groups. ResultsThe serum level of GP73 increased with increasing liver inflammatory activity and fibrosis degree in both groups; in group A, the serum level of GP73 was significantly correlated with liver inflammatory activity and fibrosis degree (r=0.529 and 0.434, both P<0.001), and a similar result was obtained in group B (r=0418 and 0.437, both P<0.001). The areas under the receiver operating characteristic curve of serum GP73 to diagnose G≥2 liver inflammation and necrosis and G≥3 inflammation and necrosis were 0.774 (95% confidence interval [CI]: 0.733-0.811, P<0.001) and 0.844 (95%CI: 0.808-0.875, P<0.001) in group A and 0.730 (95%CI: 0.663-0.790, P<0.001) and 0.716 (95%CI: 0.649-0777, P<0.001) in group B. With the help of alanine aminotransferase (ALT) combined with serum GP73, 77.4% of the patients in group A and 789% of the patients in group B were found to have G≥2 and/or S≥2 disease. ConclusionSerum GP73 can be used in combination with ALT to identify the CHB patients that need antiviral therapy and thus reduce the dependence on liver biopsy.
【关键字】:肝炎,乙型,慢性; 高尔基体蛋白73; 丙氨酸转氨酶; 诊断
【Key words】:hepatitis B, chronic; Golgi protein 73; alanine transaminase; diagnosis
【引证本文】:YAO MJ, WANG LJ, GUAN GW, et al. Value of serum Golgi protein 73 in assisting the diagnosis of moderate or severe liver injury in patients with chronic hepatitis B[J]. J Clin Hepatol, 2018, 34(4): 755-759. (in Chinese)
姚明解, 王雷婕, 关贵文, 等. 血清高尔基体蛋白73在辅助诊断慢性乙型肝炎患者中度以上肝损伤中的应用[J]. 临床肝胆病杂志, 2018, 34(4): 755-759.

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