白介素-22和肝纤四项检测对肝纤维化程度的诊断价值

Diagnostic values of interleukin-22 and four items detection of liver fibrosis on liver fibrosis degree

目的观察白介素-22(IL-22)和肝纤4项检测对肝纤维化程度的诊断价值。方法选取2013年12月～2017年12月东莞市塘厦医院收治的90例经穿刺活检诊断为肝纤维化的患者为研究对象,比较不同病理分期肝纤维化患者血清IL-22及肝纤4项[透明质酸(HA)、Ⅳ型胶原(C-Ⅳ)、Ⅲ前胶原氨基端肽(PⅢNP)层粘连蛋白(LN)]的水平差异,分析上述血清学指标与肝纤维化程度的相关性以及其对肝纤维化程度的诊断价值。结果血清IL-22、HA、C-Ⅳ、PⅢNP、LN水平随肝纤维化程度加重而升高,差异有统计学意义(P<0.05)。Spearman相关分析显示,血清IL-22、HA、C-Ⅳ、PⅢNP、LN水平与肝纤维化程度成显著正相关(r=0.634、0.612、0.563、0.551、0.547,P<0.05);血清IL-22、HA、C-Ⅳ、PⅢNP、LN水平联合检测对肝纤维化程度诊断准确率(DA)84.68%显著高于单项检测(77.59%)(P<0.05)。结论血清IL-22和肝纤4项水平随肝纤维化程度加重而升高,与肝纤维化程度成显著正相关,上述指标联合检测可显著提升对肝纤维化程度的诊断准确率。

Objective To observe the diagnostic values of interleukin-22 （IL-22） and four items detection of liver fi- brosis on the liver fibrosis degree. Methods A fatal of 90 eases of patients diagnosed with liver fibrosis by needle biop- sy in Tangxia Hospital of Dongguan City from Deeember 2013 to Deeember 2017 were seleeted as the subjeets. The levels of serum IL-22 and four items of liver fibrosis [hyaluronie aeid （HA）, eollagen type Ⅳ （C-Ⅳ）, proeollagen Ⅲ N-terminal peptide （PⅢ NP）, laminin （LN）] were eompared in patients with liver fibrosis at different pathologieal stages, and the eorrelation between the above serologieal indexes and the liver fibrosis degree and its diagnostie values on the liver fibrosis degree were analyzed. Results The serum levels of IL-22, HA, C-IV, PⅢNP and LN were inereased with the severity of liver fibrosis （P〈0.05）. Spearman correlation analysis showed that serum levels of IL-22, HA, C-Ⅳ, PⅢ NP and LN were signifieantly and positively eorrelated with the liver fibrosis degree （r=0.634, 0.612, 0.563, 0.551, 0.547, P〈0.05）. The diagnostie aeeuraey of liver fibrosis degree was 84.68% by eombined diagnosis of serum IL-22, HA, C- Ⅳ, PⅢNP and LN, whieh was signifieantly higher than that by single deteetion with 77.59% （P〈0.05）. Con- clusion The levels of serum IL-22 and four items of liver fibrosis are increased with the severity of liver fibrosis, and there is a signifieant positive eorrelation with liver fibrosis degree. The eombined deteetion of above indexes ean signifi- eantly improve the diagnostie aeeuraey of liver fibrosis degree.