sCD163在非酒精性脂肪肝儿童血清中的表达水平及其与传统肝纤维化血清学指标的相关性

Correlation between serum sCD163 expression level in nonalcoholic fatty liver and serological markers of traditional liver fibrosis

目的探讨可溶性CD163(sCD163)在非酒精性脂肪性肝病儿童血清中的表达水平及其与传统肝纤维化血清学指标的相关性分析。方法选取我院2016年10月～2017年4月就诊的非酒精性脂肪肝儿童76例,收集患儿各项临床资料。根据患者疾病类型,将76例患儿分为单纯性非酒精性脂肪肝(NAFL)组(31例)、非酒精性脂肪性肝炎(NASH)组(45例),另选取同期我院健康体检患儿30例作为健康对照组,比较3组儿童sCD163水平,采用Spearman等级相关分析非酒精性脂肪性肝病患儿sCD163血清水平与传统肝纤维化血清学指标的相关性,绘制血清sCD163诊断非酒精性脂肪性肝病患儿肝纤维化的受试者工作特征曲线(ROC),计算曲线下面积及血清sCD163诊断非酒精性脂肪性肝病患者肝纤维化的敏感性、特异性。结果 3组儿童血清sCD163水平差异均有统计学意义(P<0.001),NASH组患儿血清sCD163水平明显高于健康对照组及NAFL组,差异均有统计学意义(P<0.05);经Spearman相关分析后结果显示:非酒精性脂肪性肝病患儿血清sCD163与层粘连蛋白(LN)、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)指标均呈现正相关性(P<0.001);通过绘制ROC曲线,在血清sCD163取82.18μg/L时,曲线下面积为0.907(95%Cl:0.883～0.931),血清sCD163诊断非酒精性脂肪性肝病患者肝纤维化的敏感性、特异性分别为84.66%、86.91%。结论非酒精性脂肪肝儿童血清sCD163中的表达水平较正常健康者高,血清sCD163与传统肝纤维化血清学指标存在正相关性,sCD163可作为评估非酒精性脂肪肝儿童肝纤维化的临床指标。

Objective To investigate the correlation between serum soluble CD163 (sCD163) expression level in nonalcoholic fatty liver and serological markers of traditional liver fibrosis.Methods 76 children with non-alcoholic fatty liver disease admitted to our hospital from October 2016 to April 2017 were selected and divided into nonalcoholic fatty liver (NAFL group,n=31) and nonalcoholic steatohepatitis (NASH group,n=45).Another 30 health examinees were set as healthy control group.The sCD163 levels of three groups were compared.Spearman rank correlation analysis was used to analyze the correlation between serum levels of sCD163 and serum markers of traditional liver fibrosis.The receiver operating characteristic (ROC) curve was drawn to calculate the sensitivity and specificity of serum sCD163 in diagnosis of liver fibrosis in patients with nonalcoholic fatty liver disease.Results The gender,age,weight,BMI,waist circumference,waist-to-hip ratio,total cholesterol,and fasting blood glucose levels between the NAFL group and the NASH group had no difference ( P >0.05).The serum sCD163 levels of three groups had statistic difference (F=166.72,P <0.001),which was highest in the NASH group than in the healthy control group and the NAFL group ( P <0.05).Spearman correlation analysis showed that serum sCD163 was positively correlated with LN,HA,PCIII and CIV in patients with nonalcoholic fatty liver disease ( P <0.001).When the serum sCD163 was 82.18μg/L,the area under the ROC curve,sensitivity and specificity of serum sCD163 in the diagnosis of liver fibrosis were 0.907 (95% Cl: 0.883~0.931),84.66% and 86.91%.Conclusion The expression level of serum sCD163 in children with nonalcoholic fatty liver is higher than that of normal healthy people,which was positively correlated with the serological markers of traditional liver fibrosis,indicated that the sCD163 can be used as a clinical index to evaluate liver fibrosis.