摘要
目的分析血清视黄醇结合蛋白4(RBP4)、核因子κB(NF-κB)表达与肝内胆管结石患者术后复发的关系。方法选取2017年1月至2018年12月该院接受肝内胆管结石术治疗的143例肝内胆管结石患者为研究对象,依据术后6个月是否复发分为复发组与未复发组,比较两组一般资料、检测实验室指标,观察血清RBP4、NF-κB水平与肝内胆管结石经肝内胆管结石术后复发的关系。结果143例肝内胆管结石患者术后复发21例,复发率为14.69%;两组年龄、性别、体质量比较,差异无统计学意义(P>0.05);复发组RBP4、NF-κB、Toll样受体4(TLR4)、促甲状腺激素(TSH)水平均高于未复发组,差异有统计学意义(P<0.05);相关性分析发现,肝内胆管结石患者血清RBP4水平与NF-κB水平之间呈正相关关系(r=0.472,P<0.001);经单因素分析与多因素Logistic回归分析结果显示,血清RBP4、NF-κB、TLR4及TSH水平升高是肝内胆管结石患者术后复发的影响因素(OR>1,P<0.05),绘制ROC曲线结果显示,血清RBP4、NF-κB、TLR4、TSH水平单独及联合预测肝内胆管结石患者术后复发风险的曲线下面积(AUC)均>0.80,预测价值较理想,在血清RBP4、NF-κB、TLR4、TSH的cut off值分别取13.121μg/mL、142.316 ng/L、7.135 ng/mL、6.170 mU/L时,可获得最佳预测价值。结论肝内胆管结石患者术后复发可能与血清RBP4、NF-κB过表达有关,临床可考虑通过检测患者血清RBP4、NF-κB水平来预测患者术后复发风险,以指导早期风险评估与防治。
Objective To analyze the relationship between the expression of serum retinol binding protein 4(RBP4)and nuclear factorκB(NF-κB)and the recurrence of patients with calculus of intrahepatic duct.Methods A total of 143 patients with calculus of intrahepatic duct who underwent calculus of intrahepatic duct surgery in our hospital from January 2017 to December 2018 were selected.According to whether they recurred after 6 months of operation,they were divided into a recurrence group and a non-recurrence group.The general data of the two groups were investigated,the laboratory indicators were tested and compared,the relationship between serum RBP4,NF-κB levels and the recurrence of calculus of intrahepatic duct after operation were observed.Results Among all 143 patients with calculus of intrahepatic duct,21 had recurrence after surgery,with a recurrence rate of 14.69%.The differences on the age,gender and body mass between the two groups had no statistically significant(P>0.05);the levels of RBP4,NF-κB,Tollreceptor 4(TLR4)and thyroid stimulating hormone(TSH)in the recurrence group were higher than those in the non-recurrence group,the differences were statistically significant(P<0.05).Correlation analysis found that there was a positive correlation between serum RBP4 level and NF-κB level in patients with calculus of intrahepatic duct(r=0.472,P<0.001).The results of single factor and multiple Logistic regression analysis showed that the increased levels of serum RBP4,NF-κB,TLR4 and TSH were the influencing factors for the recurrence of calculus of intrahepatic duct after surgery(OR>1,P<0.05),the results of drawing ROC curve showed that the area under the curve(AUC)of serum RBP4,NF-κB,TLR4 and TSH levels alone and in combination to predict the risk of recurrence in patients with calculus of intrahepatic duct after surgery were all>0.80,and the predictive value was ideal,when the cut-off values of RBP4,NF-κB,TLR4 and TSH were 13.121μg/mL,142.316 ng/L,7.135 ng/mL and 6.170 mU/L respectively,the best predictive value was obtained.Conclusion Postoperative recurrence of calculus of intrahepatic duct may be related to the overexpression of serum RBP4 and NF-κB.Clinically,the detection of serum RBP4 and NF-κB levels in patients can be considered to predict the risk of postoperative recurrence in patients,in order to guide early risk assessment and prevention.
作者
王太成
宋文渊
赵红岩
吴雷
陆路
WANG Taicheng;SONG Wenyuan;ZHAO Hongyan;WU Lei;LU Lu(Department of Hepatobiliary Surgery,Second Affiliated Hospital of Hainan Medical College,Haikou,Hainan 570100,China)
出处
《国际检验医学杂志》
CAS
2021年第14期1695-1699,共5页
International Journal of Laboratory Medicine
基金
海南省卫生计生行业科研项目(1801320712A2091)。
关键词
肝内胆管结石
复发
视黄醇结合蛋白4
核因子ΚB
相关性
calculus of intrahepatic duct
recurrence
retinol binding protein 4
nuclear factorκB
correlation
