血清铁蛋白含量与HBV相关慢性肝病的临床相关性

Relationship between serum ferritin level and HBV related chronic liver disease

目的研究HBV相关慢性肝病患者血清铁蛋白(SF)含量及其与肝功能血清学指标的相关性,进一步探讨铁蛋白在诊断HBV相关慢性肝病中的价值。方法选取2016年1~6月于安徽医科大学第二附属医院就诊的慢性乙型肝炎患者(CHB)27例、肝硬化代偿期患者(LC)17例、肝硬化失代偿期患者(DLC)30例及健康对照者30例。采用免疫比浊法分析患者SF含量,采用Spearman秩相关分析SF含量与血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、白蛋白(ALB)、前白蛋白(PALB)、总胆红素水平(TBIL)的相关性,运用受试者工作特征(ROC)曲线评价SF能否作为鉴别诊断LC与DLC的临床指标。结果与对照组相比,CHB患者与LC患者的SF水平明显升高,DLC患者SF水平明显低于CHB患者。与LC患者相比,DLC患者SF水平明显降低。CHB患者与LC患者间SF水平差异无统计学意义。ROC曲线显示,采用SF诊断LC与DLC的曲线下面积为0.816,敏感性为56.67%,特异性为94.12%,界值为66.3。Spearman分析显示,CHB患者SF水平与ALT、AST、TBIL水平呈显著正相关,与ALB、PALB水平呈显著负相关;LC患者SF水平与ALT、AST、TBIL水平呈显著正相关;DLC患者SF水平与ALB、PALB、TBIL水平呈显著正相关。结论 SF水平与HBV相关慢性肝病的进展具有相关性,可作为临床鉴别诊断LC与DLC的血清学指标和判断HBV相关肝病损伤的潜在指标。

Objective To observe the correlation between the level of serum ferritin （SF） and serum markers of liver function in chronic hepatitis disease, and explore the diagnostic value of ferritin in HBV related chro nic liver disease. Methods 74 subjects with HBV infection were enrolled in our hospital from January to June in 2016, ineluding 27 patients with chronic hepatitis B （CHB）, 17 patients with HBV-related liver cir- rhosis （LC） and 30 patients with HBV-related decompensated liver cirrhosis （DI.C）, with 30 healthy indi- viduals as the controls. The level of SF was detected with turbidimetric immunoassay; the relationships be- tween SF and AI.T, AST, ALB, PALB and TBIL were analyzed by using Spearman rank correlation; the receiver operating characteristic （R（）C） curve was used to evaluate whether SF could be used as a clinical in dieator for the differentiation between LC and DLC. Results The SF levels of patients with CHB and LC were significantly higher than those of healthy controls, and those of DLC patients were lower than those of CHB pa tients. Compared with I.C patients, the levels of SF in DLC patients were much lower, while there was no signifi cant difference between CHB patients and I.C patients in SF expression. The ROC curve showed that the area under the curve of LC and DLC diagnosed by SF was 0. 816, with the sensitivity being 56.67%, the specificity being 94.12%, and the boundary value being 66.3. Spearman correlation analysis showed that SF was positively correla- ted with ALT, AST and TBIL while negatively correlated with ALB and PALB＇ in CHB patients; it was signifi- cantly positively correlated with ALT, AST and TBIL in LC patiems, and with ALB, PALB and TBIL in DLC pa- tients. Conclusion SF is associated with the progression of HBV related chronic liver disease. It may serve as a potential biomarker for the differentiation between LC and DLC, and the diagnosis of HBV related liver damage.