摘要
目的分析自身免疫性肝炎患者甘露糖结合凝集素相关丝氨酸蛋白酶2(MASP-2)和补体因子H水平与疾病严重程度及复发的关系。方法回顾性分析2020年2月至2021年2月在延安市人民医院诊治的60例自身免疫性肝炎患者的临床资料,将其作为观察组,其中男性17例,女性43例,年龄(52.71±3.58)岁,根据Child-Pugh分级将其分为A级组(26例)、B级组(22例)、C级组(12例),另根据随访1年结果将其分为复发组(15例)和未复发组(45例)。并选取同期60例在延安市人民医院体检的健康人群作为对照组,其中男性13例,女性47例,年龄(52.64±3.62)岁。采用t检验或重复测量方差分析比较不同组别之间的MASP-2、补体因子H水平差异;采用Spearman相关性分析MASP-2、补体因子H水平与Child-Pugh分级之间的相关性,采用受试者操作特征曲线(ROC)分析MASP-2、补体因子H水平预测自身免疫性肝炎患者复发的价值。结果观察组MASP-2、补体因子H水平分别为(91.89±15.74)μg/L、(66.28±12.58)mg/L,均低于对照组的(262.93±35.63)μg/L、(145.31±25.71)mg/L,差异均有统计学意义(t=31.013、21.387,均P<0.001)。A级、B级组MASP-2、补体因子H水平分别为(106.72±16.52)μg/L、(84.94±14.73)μg/L、(76.87±12.46)mg/L、(61.66±9.38)mg/L,均高于C级组的(72.80±12.59)μg/L、(52.12±8.89)mg/L,且A级组均高于B级组,差异均有统计学意义(均P<0.05)。复发组MASP-2、补体因子H水平分别为(78.30±13.66)μg/L、(56.20±8.53)mg/L,均低于未复发组的(96.48±15.57)μg/L、(69.61±7.36)mg/L,差异均有统计学意义(t=4.030、5.893,均P<0.001)。Spearman相关性分析显示,MASP-2、补体因子H水平与Child-Pugh分级均呈负相关(r=-0.721、-0.748,均P<0.05)。ROC分析结果显示,MASP-2、补体因子H水平在预测自身免疫性肝炎患者复发中具有较高的价值,曲线下面积(AUC)分别为0.823、0.877。结论随着病情加重,自身免疫性肝炎患者MASP-2、补体因子H水平均降低,该两项指标在预测自身免疫性肝炎患者病情复发中具有较高的价值,可用于评估病情严重程度和预后情况。
Objective To analyze the relationships between the levels of mannose associated serine protease 2(MASP-2)and complement factor H and the severity and recurrence of autoimmune hepatitis.Methods A retrospective analysis was conducted on the clinical data of 60 patients with autoimmune hepatitis treated in Yan'an People's Hospital from February 2020 to February 2021.They were selected as the observation group,consisting of 17 males and 43 females,with an age of(52.71±3.58)years old.According to the Child-Pugh grading system,they were divided into grade A group(26 cases),grade B group(22 cases),and grade C group(12 cases).Additionally,based on the 1-year follow-up results,they were divided into a recurrent group(15 cases)and a non-recurrent group(45 cases).A total of 60 healthy individuals who underwent physical examinations in Yan'an People's Hospital during the same period were selected as the control group,with 13 males and 47 females,with an age of(52.64±3.62)years old.t test or repeated measure analysis of variance was used to compare the MASP-2 and complement factor H levels among different groups.Spearman correlation analysis was used to analyze the correlations between MASP-2 and complement factor H levels and Child-Pugh grading.The value of MASP-2 and complement factor H levels in predicting recurrence in patients with autoimmune hepatitis was analyzed by receiver operating characteristic curve(ROC).Results The levels of MASP-2 and complement factor H in the observation group were(91.89±15.74)μg/L and(66.28±12.58)mg/L,which were lower than those in the control group[(262.93±35.63)μg/L and(145.31±25.71)mg/L],with statistically significant differences(t=31.013 and 21.387,both P<0.001).The levels of MASP-2 and complement factor H in grade A and B groups were(106.72±16.52)μg/L,(84.94±14.73)μg/L,(76.87±12.46)mg/L,and(61.66±9.38)mg/L,which were higher than those in group C[(72.80±12.59)μg/L and(52.12±8.89)mg/L],and those in group A were higher than those in group B,with statistically significant differences(all P<0.05).The levels of MASP-2 and complement factor H in the recurrent group were(78.30±13.66)μg/L and(56.20±8.53)mg/L,which were lower than those in the non-recurrent group[(96.48±15.57)μg/L and(69.61±7.36)mg/L],with statistically significant differences(t=4.030 and 5.893,both P<0.001).Spearman correlation analysis showed that the MASP-2 and complement factor H levels were negatively correlated with Child-Pugh grading(r=-0.721 and-0.748,both P<0.05).ROC analysis showed that the MASP-2 and complement factor H levels had high value in predicting recurrence in autoimmune hepatitis patients,and the area under the curve(AUC)was 0.823 and 0.877,respectively.Conclusion With the exacerbation of the disease,the levels of MASP-2 and complement factor H decrease in patients with autoimmune hepatitis,and these two indicators have high value in predicting the recurrence of autoimmune hepatitis patients,which can be used to assess the severity and prognosis of the disease.
作者
何学学
杨宁
折慧
He Xuexue;Yang Ning;Zhe Hui(Department of Infectious Diseases(Department of Hepatology),Yan'an People's Hospital,Yan'an 716000,China;Department of Emergency,Yan'an People's Hospital,Yan'an 716000,China)
出处
《国际医药卫生导报》
2024年第14期2375-2379,共5页
International Medicine and Health Guidance News
基金
陕西省重点研发计划(2021SF-223)。
