HBV相关性慢加急性肝衰竭患者血清sMR、suPAR表达水平及临床意义

Changes and clinical significance of serum sMR and suPAR in patients with chronic hepatitis B virus-associated chronic acute liver failure

目的:探讨HBV相关慢加急性肝衰竭(HBV-ACLF)患者血清可溶性甘露糖受体(sMR)、可溶性尿激酶型纤溶酶原激活物受体(suPAR)水平变化及临床意义。方法:回顾性分析2017年1月至2019年11月我科收治的136例HBV-ACLF患者(病例组)血清sMR、suPAR水平变化,并选取健康体检者100例(对照组)与之比较。采用ELISA法检测两组人员血清sMR、suPAR水平。采用Pearson法分析血清sMR、suPAR与肝功能指标的相关性;对HBV-ACLF患者随访90 d,根据患者生存情况分为生存组(77例)和死亡组(59例),采用多因素logistic回归分析影响HBV-ACLF患者预后的危险因素。结果:病例组患者的血清sMR、suPAR水平高于对照组(P<0.05);死亡组患者血清sMR、suPAR水平高于生存组(P<0.05)。血清sMR、suPAR与MELD评分、ALT、AST、TBil呈正相关(P<0.05)。血清sMR、suPAR联合检测预测HBV-ACLF患者死亡的AUC为0.919,敏感度和特异度分别为0.895和0.812。多因素logistic回归分析示:血清sMR、suPAR水平升高是影响HBV-ACLF患者预后不良的重要危险因素。结论:HBV-ACLF患者血清sMR、suPAR水平升高,血清sMR、suPAR水平与HBV-ACLF患者的病情进展密切相关,sMR、suPAR联合检测对评估HBV-ACLF患者的预后有较高价值。

Objective:To investigate the serum levels of soluble mannose receptor(sMR)and soluble urokinase-type plasminogen activator receptor(suPAR)in patients with chronic hepatitis B virus-associated chronic liver failure(HBV-ACLF)significance.Methods:One hundred and thirty-six HBV-ACLF patients(case group)from January 2017 to November 2019 were selected in our department.Another 100 healthy people(control group)were selected.HBV-ACLF patients were followed up for 90 days and were divided into survival group(77 cases)and death group(59 cases)according to their survival.Serum sMR and suPAR levels were detected by ELISA.Pearson correlation method was used to analyze the correlation between serum sMR,suPAR,and liver function indexes.Multivariate logistic regression analysis was used to influence the risk factors of poor prognosis in HBV-ACLF patients.Results:The serum sMR and suPAR levels of the patients in the case group were higher than those in the control group(P<0.05).Serum sMR and suPAR levels in the death group were higher than those in the control group(P<0.05).Serum sMR and suPAR were positively correlated with MELD score,ALT,AST,and TBil(P<0.05).The combined detection of serum sMR and suPAR predicted the death of HBV-ACLF patients with AUC of 0.919,sensitivity and specificity of 0.895 and 0.812,respectively.Multivariate logistic regression analysis showed that elevated serum sMR and suPAR levels are important risk factors affecting the poor prognosis of HBV-ACLF patients.Conclusion:The serum sMR and suPAR levels of HBV-ACLF patients are increased.Serum sMR and suPAR levels are closely related to the progression of HBV-ACLF patients.The combined detection of sMR and suPAR is of high value in evaluating the poor prognosis of HBV-ACLF patients.