乙型肝炎肝硬化患者肝功能分级与过敏毒素C3a水平的相关性
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摘要
目的研究乙型肝炎肝硬化患者肝功能分级与过敏毒素C3a水平的相关性,并绘制ROC曲线测定界值,来探索过敏毒素C3a在乙型肝炎肝硬化诊治中的意义。方法共纳入195例患者,检查血液过敏毒素C3a值、总胆红素值、白蛋白值、凝血酶原时间及腹水与肝性脑病情况,采用Child-Pugh改良分级法评估患者肝功能。另取20例乙肝病毒携带者作为对照组。结果肝功能C级组C3a水平较B级组降低(P<0.01);两组均较肝功能A级组及对照组降低(均P<0.01)。肝功能受损程度越重,乙型肝炎肝硬化患者血液中C3a浓度越低。结论乙型肝炎肝硬化患者肝功能Child-Pugh分级与其血液中过敏毒素C3a水平呈负相关性,血液中C3a水平可用于乙型肝炎肝硬化患者肝功能水平的评估。
Objective To investigate the correlation between liver function classification and levels of C3a in patients with hepatitis B cirrhosis,and to draw the ROC curve determination to explore the clinical significanceof C3a in the diagnosis and treatment of hepatitis B cirrhosis. Methods A total of 195 patients were enrolled inthis study,blood anaphylatoxin C3a value,total bilirubin,albumin,prothrombin time and ascites and hepaticencephalopathy were checked,and the modified Child-Pugh classification method was used to assess the liverfunction. Another 20 hepatitis B virus carriers were selected as control group. Results The level of C3a in the liverfunction class C group was lower than that in the B group(P < 0.01),however,levels of C3a in the two groupswere lower than those in the liver function class A and the control group(P < 0.01). The more serious the impair-ment of liver function,the lower the concentration of C3a in the blood of patients with hepatitis B cirrhosis wasobserved. Conclusions The Child-Pugh classification of liver function in patients with hepatitis B cirrhosis isinversely related with the level of C3a in the blood,and the level of C3a in the blood can be used to evaluate theliver function of patients with hepatitis B cirrhosis.
Objective To investigate the correlation between liver function classification and levels of C3a in patients with hepatitis B cirrhosis,and to draw the ROC curve determination to explore the clinical significanceof C3a in the diagnosis and treatment of hepatitis B cirrhosis. Methods A total of 195 patients were enrolled inthis study,blood anaphylatoxin C3a value,total bilirubin,albumin,prothrombin time and ascites and hepaticencephalopathy were checked,and the modified Child-Pugh classification method was used to assess the liverfunction. Another 20 hepatitis B virus carriers were selected as control group. Results The level of C3a in the liverfunction class C group was lower than that in the B group(P < 0.01),however,levels of C3a in the two groupswere lower than those in the liver function class A and the control group(P < 0.01). The more serious the impair-ment of liver function,the lower the concentration of C3a in the blood of patients with hepatitis B cirrhosis wasobserved. Conclusions The Child-Pugh classification of liver function in patients with hepatitis B cirrhosis isinversely related with the level of C3a in the blood,and the level of C3a in the blood can be used to evaluate theliver function of patients with hepatitis B cirrhosis.
引文
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[17]李广波,刘翠华,厉洪江.补体C3低于正常非典型溶血尿毒综合征的治疗[J].实用医学杂志,2017,33(14):2422-2423.
[2]PINZANI M,ROSSELLI M,ZUCKERMANN M.Liver cirrhosis[J].Best Pract Res Clin Gastroenterol,2011,25(2):281-290.
[3]ZHOU J,DENG Y,YAN L,et al.Serum platelet-derivedgrowth factor BB levels:a potential biomarker for the assess-ment of liver fibrosis in patients with chronic hepatitis B[J].Int J Infect Dis,2016,49:94-99.
[4]CUI Y,JIA J.Update on epidemiology of hepatitis B and C inChina[J].J Gastroenterol Hepatol,2013,28(S1):7-10.
[5]HACKL C,SCHLITT H J,RENNER P.Liver surgery in cirrho-sis and portal hypertension[J].World J Gastroenterol,2016,22(9):2725-2735.
[6]SIPEKI N,ANTAL-SZALMAS P,LAKATOS P L,et al.Im-mune dysfunction in cirrhosis[J].World J Gastroenterol,2014,20(10):2564-2577.
[7]SAYEGH E T,BLOCH O,PARSA A T.Complement anaphyla-toxins as immune regulators in cancer[J].Cancer Med,2014,3(4):747-758.
[8]ALPER C,JOHNSON A,BIRTCH A,et al.Human C3:evi-dence for the liver as the primary site of synthesis[J].Science,1969,163(3864):286-287.
[9]谢亮,程树林,李一竹,等.过敏毒素C3a与前列腺增生症合并组织炎症的关系[J].四川大学学报(医学版),2011,42(5):642-645.
[10]COULTHARD L G,WOODRUFF T M.Is the complement acti-vation product C3a a proinflammatory molecule Re-evaluatingthe evidence and the myth[J].J Immunol,2015,194(8):3542-3548.
[11]KLOS A,TENNER A J,JOHSWICH K O,et al.The role ofthe anaphylatoxins in health and disease[J].Mol Immunol,2009,46(14):2753-2766.
[12]MASTELLOS D C,DEANGELIS R A,LAMBRIS J D.Comple-ment-triggered pathways orchestrate regenerative responsesthroughout phylogenesis[J].Semin Immunol,2013,25(1):29-38.
[13]DEANGELIS R A,MARKIEWSKI M M,KOUETZELIS I,etal.A complement-IL-4 regulatory circuit controls liver regenera-tion[J].J Immunol,2012,188(2):641-648.
[14]GLARGAARD S,BOYSEN T,PILELY K,et al.Prognosticvalue of lectin pathway molecules and complement proteins inascitic fluid and blood in patients with liver cirrhosis[J].ScandJ Gastroenterol,2018,53(1):64-69.
[15]DAUGAN M,NOE R,HERMAN F W,et al.The complementsystem:a double edge sword in tumor progression[J].Med Sci(Paris),2017,33(10):871-877.
[16]VLAICU S I,TATOMIR A,BOODHOO D,et al.The role ofcomplement system in adipose tissue-related inflammation[J].Immunol Res,2016,64(3):653-664.
[17]李广波,刘翠华,厉洪江.补体C3低于正常非典型溶血尿毒综合征的治疗[J].实用医学杂志,2017,33(14):2422-2423.