摘要
目的分析血清高尔基体蛋白73(GP73)和血清自噬相关蛋白p62水平对乙型肝炎病毒相关慢加急性肝衰竭(ACLF)患者短期预后的临床价值及预测差异。方法回顾性分析本院2018年10月- 2020年4月收治的HBV相关ACLF患者32例的临床资料(A组),选择同期乙型肝炎肝硬化患者65例(其中Child-Pugh A级为B组34例、Child-Pugh B/C级为C组31例),另选同期健康体检者30名为对照组(D组)。测定四组入选者血清GP73与p62水平,对ACLF组患者随访3个月以分析患者预后情况;并比较死亡和生存患者入院时血清GP73与p62的水平。对数据进行单因素方差分析、独立样本t检验、Pearson相关性分析;采用受试者操作特征曲线(ROC)分析GP73与p62水平对生存患者的预测价值。结果 A、B、C、D四组GP73水平分别为(284.30±70.55)ng/ml、(125.33±20.57)ng/ml、(159.82±31.20)ng/ml、(45.46±10.22)ng/ml;p62水平分别为(1.30±0.35)ng/ml、(2.88±0.58)ng/ml、(2.02±0.54)ng/ml、(4.68±1.03)ng/ml。GP73检测值A组显著高于其他三组(P < 0.05),D组显著低于其他三组(P < 0.05),C组显著高于B组(P < 0.05)。p62检测值A组显著低于其他三组(P < 0.05),D组显著高于其他三组(P < 0.05),B组略高于C组,差异有统计学意义(P < 0.05)。GP73与p62呈现负相关关系(r = -0.695,P < 0.001)。ACLF组中生存患者GP73水平显著低于死亡患者[(212.17±22.47)ng/ml与(340.08±32.91)ng/ml,t = 12.493,P < 0.05];p62水平显著高于死亡患者[(1.46±0.28)ng/ml与(1.18±0.35)ng/ml,t = 2.445,P < 0.05]。据ROC曲线分析结果显示:GP73的曲线下面积(AUC)为0.865、p62的AUC为0.750,两项联合AUC为0.968。结论 GP73与p62均对HBV相关ACLF患者近期预后具有一定预测价值,但两项指标联合预测价值更高。
Objective To analyze the clinical value and predictive difference of serum Golgi protein 73(GP73)and serum autophagy-related protein p62 levels in the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure(ACLF).Methods Clinical data of admitted cases to our hospital from October 2018 to April 2020 were retrospectively analyzed.Simultaneously,there were 32 cases with HBV-related ACLF in group A,65 cases with hepatitis B virus-related cirrhosis in group B and C(Child-Pugh Class A,34 cascs as B group,and Child-Pugh B/C class,3l cases as group C),and another 30 healthy subjects served asthe control group(group D).The serum GP73 and p62 levels of the four selected groups were measured.ACLFgroup patients were followed up for 3 months to analyze the prognosis of the patients.T he serum GP73 andp62 levels of patients who died and survived during hospitalization were compared.The data were analyzed byone-way analysis of variance,independent sample t-test,and Pearson's correlation analysis.Receiver operatingcharacteristic curve(ROC)was used to analyze the predictive value of GP73 and p62 levels in surviving patients.Results GP73 levels in the four groups A,B.C and D were(284.30±70.55)ng/ml,(125.33±20.57)ng/ml,(159.82±31.20)ng/ml,and(45.46±10.22)ng/ml,respectively.The p62 levels were(1.30±0.35)ng/ml,(2.88±0.58)ng/ml.(2.02±0.545)ng/ml,and(4.68±1.03)ng/ml,respectively.GP73 dctection value was significantlyhigher in group A than the other three groups(P<0.05).Group D had significantly lower value than the otherthree groups(P<0.05),and group C had significantly higher valuc than group B(P<0.05).The detection valueof p62 in group A was significantly lower than the other three groups(P<0.05).Group D had significantlyhigher value than the other three groups(P<0.05),and group B had slightly higher value than group C,and thedifferences were statistically significant(P<0.05).There was a negative correlation between GP73 and p62(r=-0.695,P<0.001).Survived patients GP73 level in the ACLF group was significantly lower than dead patients[(212.17±22.47)ng/ml and(340.08±32.91)ng/ml,1=12.493,P<0.05],and p62 level was significantly higherthan dead patients[(1.46±0.28)ng/ml and(1.18±0.35)ng/ml,t=2.445,P<0.05].According to the ROCcurve analysis results,the area under the curve(AUC)of GP73 was 0.865,the AUC of p62 was 0.750,and thecombined AUC of the both was 0.968.Conclusion Both GP73 and p62 have a certain predictive value forthe short-term prognosis of HBV-related ACLF paticnts,but the combination of the two indicators has a higherpredictive value.
作者
高伟
高虹
尹春梅
杨森林
范晓红
刘春亮
李雪卿
贾妮娜
Gao Wei;Gao Hong;Yin Chunmei;Yang Senlin;Fan Xiaohong;Liu Chunliang;Li Xueqing;Jia Nina(Department of Gastroenterology,the Second Hospitial of Shanxi Medical University,Taiyuan 030001,China)
出处
《中华肝脏病杂志》
CSCD
北大核心
2021年第9期855-860,共6页
Chinese Journal of Hepatology
基金
山西省面上青年基金项目(201901D211494)。
