摘要
目的分析丙型肝炎患者肝纤维化指数(FIB-4评分)、HCV RNA载量和血清25羟维生素D(25OH-D)水平之间的关系。方法收集255例丙型肝炎患者和218例表面健康人群的血清标本,检测血清25OH-D水平、HCV RNA载量以及FIB-4指数评分标准中的3项指标[包括丙氨酸氨基转移酶(ALT)、谷氨酸氨基转移酶(AST)和血小板(PLT)]。比较丙型肝炎组与健康对照组之间25OH-D浓度的差异;根据FIB-4评分标准分组,统计HCV RNA载量、25OH-D浓度和FIB-4指数之间的关系。结果丙型肝炎组25OH-D浓度为48.16±1.41 nmol/L,明显低于对照组(60.42±1.34 nmol/L;t=4.682,P<0.01)。丙型肝炎组中25OH-D缺乏(<50 nmol/L)和严重缺乏(<25 nmol/L)的比例为42.35%(108/255)和14.90%(38/255),明显高于对照组[27.98%(91/218)和3.67%(8/218);t=5.21 6,P<0.01)]。相关性分析表明HCV RNA阳性组病毒载量对数值与相应的25OH-D水平无相关性(r2=0.018 8,P=0.412)。根据25OH-D水平四分位分组,25OH-D水平浓度随FIB-4指数增加而减低,各组中不同纤维化程度的丙型肝炎患者比例差异有统计学意义(x^2=8.190,P=0.042);根据HCV RNA载量四分位分组,FIB-4指数分级各组间患者例数分布差异无统计学意义(x^2=1.874,P>0.05)。结论丙型肝炎患者25OH-D水平显著低于健康对照组,对此类人群应适当补充维生素D。丙型肝炎患者FIB-4指数和25OH-D浓度显著相关,和HCVRNA病毒载量不相关。
Objective To analyze the effects of 25-hydroxyvitamin D[25（OH）D] on the result of the HCV RNA and the FIB- 4 in the patients with hepatitis C. Methods 255 serum samples were random collected from the patients with hepatitis C and 218 serum samples were random collected from the healthy people. The 25 （OH）D, HCV RNA, aspartate aminotransferase （AST） ,alanine amlnotransferase （AI.T） and blood platelet （PLT） were detected. Then, compared the results of the 25 （OH）D in the patients with hepatitis C and the healthy group. Analyzed the relevance between the concentration of 25（OH） D and HCV RNA. According to the quartile concentration of the 25 （OH）D, the patients with hepatitis C were categorized to four groups. The relationship of FIB-4 between HCVRNA and 25（OH）D was analyzed. Results The average concentration of the 25（OH）D in the patients with hepatitis C and healthy people were 48. 16± 1.41 nmol/L vs 60. 424±1.34 nmol/L, with a significant difference （t =4. 682,P〈0.01）. There were 38 patients （14.90%） had severe deficiency of 25（OH）D （〈25 nmol/L） in 255 patients with hepatitis C. And there were 8 patients （3.67%） had severe deficiency of 25（OH）D （〈25 nmol/L） in 218 healthy people, with a significant difference （t=5.216, P〈0.01）. Then found no relevance between the logarithmic of the HCV RNA and the concentration of the 25（OH）D （r2=0. 018 8,P=0. 412） and there was significant differ ence between the proportion of FIB-4 in the highest quartile concentration of the 25（OH）D and the lowest quartile concen- tration of the 25（OH）D （χ2 =8. 190,P〈0. 042）. Conclusion The patients with hepatitis C were easier to have a severe de- ficiency of 25（OH）D than the healthy people. The hepatitis C patients should been suggested to supply the vitamin D. FIB-4 has a significant difference with 25（OH）D and no great effects on the result of the HCV RNA.
出处
《现代检验医学杂志》
CAS
2017年第1期30-33,37,共5页
Journal of Modern Laboratory Medicine
基金
上海青年临床医技人才(临床检验专业)培养资助计划(沪医卫基[2016]04号
复旦大学附属中山医院青年资金(2016ZSQN-34)
国家自然基金面上项目(81572064)
上海市卫生计生系统重要薄弱学科建设项目(2015ZB0201)
