摘要
目的探讨湖北省恩施地区肝硬化患者血清硒元素水平。方法选取2016年1月-2017年6月恩施州中心医院收治的肝硬化患者90例为肝硬化组,采用Child-Pugh分类法分为A、B、C级;60例正常健康体检人群为对照组。检测其血清硒元素及肝纤维化指标。计量资料两组间比较采用t检验,多组间比较采用单因素方差分析,进一步两两比较采用SNK-q检验,相关分析采用Spearman相关检验。结果与对照组比较,肝硬化组血清硒水平明显下降,而透明质酸(HA)、Ⅲ型前胶原肽(PCⅢ)、Ⅳ型胶原(Ⅳ-C)、层黏连蛋白(LN)明显升高,差异均有统计学意义(t值分别为7.246、9.759、4.790、8.671、5.908,P值均<0.05)。随着Child-Pugh分级的递增,血清硒水平进行性下降,而HA、PCⅢ、Ⅳ-C、LN呈进行性升高,差异均有统计学意义(F值分别为13.524、53.903、21.490、52.495、19.530,P值均<0.05)。血清硒与HA、PCⅢ、Ⅳ-C、LN和Child-Pugh分级间呈负相关(r值分别为-0.361、-0.519、-0.448、-0.354、-0.602,P值均<0.05)。结论恩施地区肝硬化患者血清硒水平明显低于本地区正常人群,但补硒治疗是否能改善肝硬化预后需要进一步的临床探讨。
Objective To investigate the serum selenium level in patients with cirrhosis in Enshi,Hubei Province,China. Methods A total of 90 patients with cirrhosis who were treated in The Central Hospital of Enshi Autonomous Prefecture from January 2016 to June 2017 were enrolled as liver cirrhosis group and further divided into Child-Pugh class A,B,and C subgroups; 60 healthy volunteers who underwent physical examination were enrolled as control group. Serum selenium level and hepatic fibrosis indices were measured. The t-test was used for comparison of continuous data between two groups; a one-way analysis of variance was used for comparison of continuous data between multiple groups,and the SNK-q test was used for further comparison between two groups. The Spearman correlation test was used to investigate the correlation between serum selenium level and degree of liver cirrhosis. Results Compared with the control group,the liver cirrhosis group had a significant reduction in serum selenium level and significant increases in hyaluronic acid（ HA）,procollagen type Ⅲ（ PCⅢ）,type Ⅳ collagen（ Ⅳ-C）,and laminin（ LN）（ t = 7. 246,9. 759,4. 790,8. 671,and 5. 908,all P〈0. 05）. There was a progressive reduction in serum selenium level and progressive increases in HA,PCⅢ,Ⅳ-C,and LN with increasing Child-Pugh class（ F =13. 524,53. 903,21. 490,52. 495,and 19. 530,all P〈0. 05）. Serum selenium is negatively correlated with HA,PCⅢ,Ⅳ-C,LN,and Child-Pugh class（ r =-0. 361,-0. 519,-0. 448,-0. 354,and-0. 602,all P〈0. 05）. Conclusion Patients with cirrhosis have a significantly lower serum selenium level than the normal population in Enshi,but further clinical studies are needed to determine whether selenium supplementation can improve the prognosis of cirrhosis.
作者
郑晓丽
贺建华
向兴朝
周翔禹
雷蕾
ZHENG Xiaoli;HE Jianhua;XIANG Xingchao(The Central Hospital of Enshi Autonomous Prefecture,Enshi,Hubei 445000,China)
出处
《临床肝胆病杂志》
CAS
北大核心
2018年第7期1436-1439,共4页
Journal of Clinical Hepatology
