摘要
目的探讨血清补体C3和C4预测慢性乙型肝炎肝组织炎症活动度和纤维化程度的价值。方法416例经肝组织病理学检查的慢性乙型肝炎患者人选本研究。血清补体C3和C4采用Beckman—Coulter Immage800免疫化学系统及其配套试剂测定。结果血清补体C3和C4预测显著炎症(≥G2)、中度炎症(≥G3)、重度炎症(=G4)的ROC曲线下面积分别为0.602(95%CI:0.545—0.659)和0.550(95%CI:0.489—0.611)、0.620(95%CI:0.559~0.681)和0.606(95%CI:0.547~0.666)、0.803(95%cI:0.670—0.937)和0.654(95%CI:0.486~0.823);预测显著纤维化(≥S2)、严重纤维化(≥S3)、肝硬化(=S4)的ROC曲线下面积分别为0.590(95%CI:0.531~0.649)和0.582(95%CI:0.519~0.644)、0.665(95%CI:0.612~0.718)和0.655(95%CI:0.602~0.707)、0.669(95%CI:0.603—0.736)和0.670(95%CI:0.607~0.734)。血清补体C3和C4预测重度炎症和肝硬化的最佳截断值分别为≤0.58g/L和≤0.12g/L,其对应的灵敏度、特异度、准确度分别为0.750和0.480、0.797和0.792、0.796和0.719。结论血清补体C3和C4分别对慢性乙型肝炎肝组织重度炎症和肝硬化有一定的预测价值。
Objective To explore the clinical value of serum complement C3 and C4 for predicting the hepatic inflammatory activities and fibrotic levels in patients with chronic hepatitis B. Methods 416 patients with chronic hepatitis B with pathological diagnoses of liver tissue were enrolled in present study. Serum complement C3 and C4 were determined by Beckman-Coulter Immage 800 immunochemistry system and auxiliary reagents ( Beckman-Coulter Inc. , USA). Results The areas under ROC curve of serum complement C3 and C4 for predicting significant inflammation( ≥G2 ), moderate inflammation ( ≥g3 ) , severe inflammation ( = G4 ) were respectively 0.602 ( 95 % CI: 0. 545-0. 659 ) and 0. 550 ( 95 % CI : 0. 489 - 0. 611 ) ,0. 620 (95% CI:0. 559-0. 681 ) and 0. 606 (95% CI:0. 547-0. 666) ,0. 803 (95% CI:O. 670- 0.937 ) and 0. 654 (95% C1:0. 486-0. 823 ) ;and those for predicting significant fibrosis(≥ S2 ) , severe fibrosis(≥s3) ,cirrhosis( = S4 ) were respectively 0. 590(95% CI:0. 531-0. 649) and O. 582(95% CI: O. 519-0.644) ,0. 665 (95% CI:0. 612-0. 718 ) and O. 655 (95% CI:O. 602-0. 707) ,0. 669 (95% CI: 0. 603-0.736) and 0.670(95% CI:0. 607-0.734). The optimal cut-offs of serum complement C3 and C4 for predicting severe inflammation and cirrhosis were respectively ≤0.58 g/L and ≤0.12 g/L, and the corresponding sensitivity, specificity, accuracy were 0. 750 and 0. 480,0. 797 and . 792,0. 796 and 0. 719. Conclusion Serum complement C3 and C4 have some value for predicting respectively hepatic severe inflammation and cirrhosis in patients with chronic hepatitis B.
出处
《临床内科杂志》
CAS
2011年第8期531-534,共4页
Journal of Clinical Internal Medicine
基金
基金项目:上海市科委科技计划项目(09411965800),国家863计划生物和医药技术领域重大/重点项目基金(2006AA02A411)
关键词
补体
乙型肝炎
病理学
ROC曲线
无创诊断
Complement
Hepatitis B
Pathology
ROC curve
Non-invasive diagnosis