sCD163在非酒精性脂肪肝患者血清中的表达水平及其与传统肝纤维化血清学指标的相关性分析
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摘要
目的分析血清中可溶性CD163(sCD163)在非酒精性脂肪肝(NAFLD)患者血清中的表达水平及其与传统肝纤维化血清学指标的相关性。方法选取本院2016年11月-2017年11月期间收治的NAFLD患者36例作为研究对象(NAFLD组),另选取同期入院体检正常的患者36例作为对照组。比较两组sCD163及肝纤维化表达水平,分析sCD163与肝纤维化指标的相关性。结果与对照组比较,NAFLD组sCD163、Ⅲ型前胶原(PC-Ⅲ)、层粘连蛋白(LN)、透明质酸(HA)及Ⅳ型胶原(Col-Ⅳ)水平均明显升高(t=12.167,P<0.05;t=19.531,P<0.05;t=6.981,P<0.05;t=28.911,P<0.05;t=20.529,P<0.05);Pearson积差相关分析发现:sCD163与PC-Ⅲ、LN、HA及Col-Ⅳ呈正相关(r=0.334,P<0.05;r=0.114,P<0.05;r=0.861,P<0.05;r=0.514,P<0.05);sCD163、PC-Ⅲ、LN、HA及Col-Ⅳ诊断NAFLD的ROC曲线下面积分别为0.924、0.768、0.806、0.712及0.794。结论随着sCD163表达水平的升高,肝纤维化程度越严重;sCD163与PC-Ⅲ、LN、HA及Col-Ⅳ呈正相关,说明sCD163可作为临床上检测NAFLD患者的评估指标。
Objective To investigate the expression level of serum sCD163 in patients with non-alcoholic fatty liver disease( NAFLD) and its correlations with serum markers of traditional liver fibrosis. Methods Thirty-six patients with NAFLD treated in our hospital between November 2016 and November 2017 were selected as the subjects( NAFLD group),and another 36 patients with normal results of physical examinations during the same period were selected as the control group. The expression of sCD163 and hepatic fibrosis were compared between the two groups,and the correlations between sCD163 and liver fibrosis were analyzed. Results Compared with the control group,the levels of sCD163,PC-Ⅲ,laminin( LN),hyaluronic acid( HA),and type Ⅳ collagen( Col-Ⅳ) were significantly higher in the NAFLD group( t = 12.167,P < 0. 05; t = 19. 531,P < 0. 05; t = 6. 981,P < 0. 05; t = 28.911,P < 0. 05; t = 20.529,P<0.05). Pearson correlation analysis revealed that sCD163 was positively correlated with PC-Ⅲ,LN,HA,and Col-IV( r = 0.334,P<0.05; r = 0.114,P<0.05; r = 0.861,P<0.05; r = 0.514,P<0.05).The areas under the ROC curve of sCD163,PC-Ⅲ,LN,HA and Col-Ⅳ in diagnosing NAFLD were 0.924,0.768,0.806,0.712 and 0.794 respectively.Conclusion With the increase of sCD163 expression levels,hepatic fibrosis gets worse. sCD163 is positively correlated with PC-Ⅲ,LN,HA and Col-Ⅳ,indicating that sCD163 can be used as an assessment index for the clinical detection of NAFLD patients.
Objective To investigate the expression level of serum sCD163 in patients with non-alcoholic fatty liver disease( NAFLD) and its correlations with serum markers of traditional liver fibrosis. Methods Thirty-six patients with NAFLD treated in our hospital between November 2016 and November 2017 were selected as the subjects( NAFLD group),and another 36 patients with normal results of physical examinations during the same period were selected as the control group. The expression of sCD163 and hepatic fibrosis were compared between the two groups,and the correlations between sCD163 and liver fibrosis were analyzed. Results Compared with the control group,the levels of sCD163,PC-Ⅲ,laminin( LN),hyaluronic acid( HA),and type Ⅳ collagen( Col-Ⅳ) were significantly higher in the NAFLD group( t = 12.167,P < 0. 05; t = 19. 531,P < 0. 05; t = 6. 981,P < 0. 05; t = 28.911,P < 0. 05; t = 20.529,P<0.05). Pearson correlation analysis revealed that sCD163 was positively correlated with PC-Ⅲ,LN,HA,and Col-IV( r = 0.334,P<0.05; r = 0.114,P<0.05; r = 0.861,P<0.05; r = 0.514,P<0.05).The areas under the ROC curve of sCD163,PC-Ⅲ,LN,HA and Col-Ⅳ in diagnosing NAFLD were 0.924,0.768,0.806,0.712 and 0.794 respectively.Conclusion With the increase of sCD163 expression levels,hepatic fibrosis gets worse. sCD163 is positively correlated with PC-Ⅲ,LN,HA and Col-Ⅳ,indicating that sCD163 can be used as an assessment index for the clinical detection of NAFLD patients.
引文
[1]杨光,窦琳,唐蔚青,等.高脂饮食和西方饮食诱导的非酒精性脂肪肝小鼠模型的特征比较[J].医学分子生物学杂志,2018,41(1):17.
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[9]代东伶,周少明,柳国胜,等.脂质代谢相关基因变异与肥胖儿童非酒精性脂肪肝易感性分析[J].临床儿科杂志,2017,35(4):241.
[10]王艳荣,张秋瓒.替米沙坦对非酒精性脂肪肝大鼠炎症反应及肝纤维化的影响[J].中国临床药理学杂志,2016,32(17):1583.
[11]贺鹏,任波,李玲,等.剪切波弹性成像技术在非酒精性脂肪性肝病诊断及肝纤维化分级中应用的初步研究[J].中国临床医学影像杂志,2017,28(9):637.
[12]王传敏,石庆凤,汤守兵,等.乙型肝炎患者血清IL-1β、γ-IFN、HA、LN和PCⅢ在肝炎肝纤维化时水平的变化及其意义[J].临床和实验医学杂志,2015,14(9):718.
[13]陈容欣,熊熙,崔云,等.CD163对儿童感染相关性噬血细胞综合征的诊断及预后判断价值[J].中华实用儿科临床杂志,2017,32(3):204.
[14]李珊珊,李璐,张丹丹,等.s CD163和铁蛋白在HBV相关慢加急性肝功能衰竭中的表达及其临床意义[J].肝脏,2014,16(10):733.
[15]杨丽弘,廖鑫,张晗,等.2型糖尿病合并非酒精性脂肪肝肝纤维化与血清25-羟维生素D水平的关系研究[J].中国糖尿病杂志,2018,26(2):1263.
[16]周琳,蒋理,范宇鹏,等.非酒精性脂肪肝与血清CK-18、肝纤维化指标的相关性分析[J].检验医学,2016,31(2):99.
[17]王福慧,侯瑞田,山秀杰,等.血清可溶性CD36及尿酸与2型糖尿病合并非酒精性脂肪性肝病相关性[J].中华实用诊断与治疗杂志,2018,32(1):87.
[18]许晓勇,张超学,时晨,等.无创检查参数对肝硬化严重食管静脉曲张的诊断价值[J].中华消化杂志,2015,35(12):825.
[19]杨立学,陈科济,尉公田.CD163在肝癌术后肝衰竭患者中的表达及其与患者预后的关系[J].中国临床研究,2016,29(8):1050.
[20]陈金军,覃国琦,陈新秀,等.可溶性CD163对慢加急性肝功能衰竭短期预后的预测价值[J].肝脏,2014,16(8):597.
[2]CHALASANI N,YOUNOSSI Z,LAVINE J E,et al.The diagnosis and management of nonalcoholic fatty liver disease:practice guidance from the american association for the study of liver diseases[J].Hepatology,2017,55(6):2005.
[3]陶叶婷,潘勤,陈光榆,等.非酒精性脂肪性肝病患者性格及情绪状态调查[J].实用肝脏病杂志,2017,22(6):713.
[4]洪智峰,陈伟健,李明霞,等.可溶性髓样细胞触发受体1(s TREM-1)与可溶性血红蛋白清道夫受体(s CD163)在呼吸机相关性肺炎诊断中的临床意义[J].临床肺科杂志,2017,22(3):431.
[5]王颖超,刘冬杰,朱桂英,等.可溶性CD163和CD25在儿童噬血细胞性淋巴组织细胞增生症诊治中的意义[J].中华儿科杂志,2015,53(11):824.
[6]中华医学会肝脏病学分会脂肪肝和酒精性肝病学组.非酒精性脂肪性肝病诊断标准[J].中华肝脏病杂志,2003,7(2):364.
[7]YAGHOUBI M,JAFARI S,SAJEDI B,et al.Comparison of fenofibrate and pioglitazone effects on patients with nonalcoholic fatty liver disease[J].Eur J Gastroenterol Hepatol,2017,29(12):1385.
[8]李毓雯,朱传龙,储安贞,等.非酒精性脂肪性肝病儿童血清人尾肢同源蛋白水平检测的临床意义[J].医学研究生学报,2017,30(1):48.
[9]代东伶,周少明,柳国胜,等.脂质代谢相关基因变异与肥胖儿童非酒精性脂肪肝易感性分析[J].临床儿科杂志,2017,35(4):241.
[10]王艳荣,张秋瓒.替米沙坦对非酒精性脂肪肝大鼠炎症反应及肝纤维化的影响[J].中国临床药理学杂志,2016,32(17):1583.
[11]贺鹏,任波,李玲,等.剪切波弹性成像技术在非酒精性脂肪性肝病诊断及肝纤维化分级中应用的初步研究[J].中国临床医学影像杂志,2017,28(9):637.
[12]王传敏,石庆凤,汤守兵,等.乙型肝炎患者血清IL-1β、γ-IFN、HA、LN和PCⅢ在肝炎肝纤维化时水平的变化及其意义[J].临床和实验医学杂志,2015,14(9):718.
[13]陈容欣,熊熙,崔云,等.CD163对儿童感染相关性噬血细胞综合征的诊断及预后判断价值[J].中华实用儿科临床杂志,2017,32(3):204.
[14]李珊珊,李璐,张丹丹,等.s CD163和铁蛋白在HBV相关慢加急性肝功能衰竭中的表达及其临床意义[J].肝脏,2014,16(10):733.
[15]杨丽弘,廖鑫,张晗,等.2型糖尿病合并非酒精性脂肪肝肝纤维化与血清25-羟维生素D水平的关系研究[J].中国糖尿病杂志,2018,26(2):1263.
[16]周琳,蒋理,范宇鹏,等.非酒精性脂肪肝与血清CK-18、肝纤维化指标的相关性分析[J].检验医学,2016,31(2):99.
[17]王福慧,侯瑞田,山秀杰,等.血清可溶性CD36及尿酸与2型糖尿病合并非酒精性脂肪性肝病相关性[J].中华实用诊断与治疗杂志,2018,32(1):87.
[18]许晓勇,张超学,时晨,等.无创检查参数对肝硬化严重食管静脉曲张的诊断价值[J].中华消化杂志,2015,35(12):825.
[19]杨立学,陈科济,尉公田.CD163在肝癌术后肝衰竭患者中的表达及其与患者预后的关系[J].中国临床研究,2016,29(8):1050.
[20]陈金军,覃国琦,陈新秀,等.可溶性CD163对慢加急性肝功能衰竭短期预后的预测价值[J].肝脏,2014,16(8):597.