血清M30、M65水平对乙型肝炎肝衰竭患者生存状况的影响

Effect of serum M30 and M65 levels on survival of patients with hepatitis B liver failure

目的探究乙型肝炎相关慢加急性肝衰竭(HBV-ACLF)患者血清M30、M65水平及其对患者生存状况的影响。方法选取2014年6月—2016年3月于哨点医院接受治疗的HBV-ACLF患者136例,同时选取慢性肝炎患者25例,健康体检者25例,采集研究对象血清,测定M30、M65含量及其他生化指标。观察三组对象入组时的生物化学指标、不同预后的HBV-ACLF患者生物化学指标及M30/M65比值与终末期肝病模型评分(MELD)情况。结果 HBV-ACLF组M30含量为(3.02±0.30)lgU/L,高于健康组(2.18±0.14)lgU/L,低于慢性肝炎组(3.15±0.31)lgU/L(P<0.05);M65含量为(3.43±0.32)lgU/L,高于慢性肝炎组(3.37±0.32)lgU/L、健康组(2.03±0.15)lgU/L(P<0.05);M30/M65值为0.38±0.12,低于慢性肝炎组0.57±0.10,明显低于健康组1.42±0.37(P<0.05)。预后死亡组:MELD得分、M65含量,均明显高于生存组(P<0.05);M30/M65比值为0.38±0.14,低于生存组0.57±0.18(P<0.05)。不同预后组患者M30含量差异无统计学意义(P>0.05)。在0.4613诊断阈值内M30/M65方法 ROC曲线下面积高于MELD评分,差异有统计学意义(P<0.05)。结论血清M30、M65水平能够反映肝细胞病变情况,M30/M65能够较为准确地评估HBV-ACLF患者的生存状况。

Objective To investigate the level of serum M30 and M65 in patients with hepatitis B related chronic acute liver failure（HBV-ACLF）and its effects on the survival of patients.Methods A total of 136 cases of hepatitis B liver failure（HBV-ACLF）treated in sentinel hospital from Jun 2014 to Mar 2016 were selected,25 cases of chronic hepatitis patients and25 cases of healthy people were selected at the same time,whose serum were collected and examined for M30 and M65 levels together with other biochemical indexes.The biochemical indexes of the three groups,biochemical parameters and M30/M65 ratios among HBV-ACLF patients with different prognosis and end stage liver disease model score（MELD）were studied.Results The M30 concentration in HBV-ACLF group was（3.02±0.30）lgU/L,which was higher than that in healthy group[（2.18±0.14）lgU/L]and lower than that of hepatitis B group[（3.15±0.31）lgU/L]（P〈0.05=.The M65 concentration was（3.43±0.32）lgU/L,which was higher than that of the chronic hepatitis group [（3.37±0.32）lgU/L]and healthy group[（2.03±0.15）lgU/L]（P〈0.05=.The ratio of M30/M65 was（0.38±0.12）,which was lower than that in chronic hepatitis group[（0.57±0.10）]and was significantly lower than that in healthy group [（1.42±0.37）]（P〈 0.05=.The scores of MELD and M65 concentration were significantly higher in the death group than that in the survival group（P〈0.05=;the M30/M65 ratio was（0.38±0.14）,which was lower than that in the survival group[（0.57±0.18）]（P〈0.05=.There was no significant difference in M30 concentration between groups of patients with different prognosis（P〈0.05）.Using0.4613 as diagnostic thresholds,the area under the ROC curve were higher than the MELD score,with statistical difference（P〉0.05=.Conclusion Serum M30 and M65 levels can reflect the condition of liver cell lesion,and M30/M65 can accurately assess the survival of HBV-ACLF patients at certain level.