慢性乙型肝炎患者血清高尔基体蛋白73及其与肝脏炎症及纤维化的相关性

The relationship between serum Golgi protein 73 and both liver inflammation and fibrosis in patients with chronic hepatitis B

目的 探讨血清高尔基体蛋白73(GP73)与慢性乙型肝炎(简称乙肝)患者肝脏炎症及纤维化的相关性。方法 选取2015年9月-2016年10月在解放军总医院第五医学中心(原解放军第302医院)住院并完成肝活检的慢性乙肝患者322例,回顾性分析患者丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、肝脏弹性检测(LSM)、FIB-4、APRI等肝组织病理炎症及纤维化指标与GP73的相关性,采用单因素及多变量Logistic回归分析评估GP73对显著肝损伤的预测价值。结果 322例慢性乙肝患者年龄18~66(39.3±10.8)岁,男231例(71.7%),女91例(28.3%)。血清GP73水平伴随肝脏炎症及肝纤维化程度加重而逐渐升高,与肝组织炎症及纤维化均呈正相关,相关系数均为0.536(P<0.001)。将同一阶段的肝脏炎症或纤维化程度进行分层分析,结果显示,血清GP73与肝脏炎症程度的相关性较强,与肝纤维化程度的相关性较弱。针对显著肝脏炎症(≥G2)及纤维化(≥S2)分别进行单因素及多因素分析,结果显示,显著肝脏炎症及肝纤维化组的血清GP73水平明显高于无或轻度肝脏炎症(G0-1)及纤维化组(S0-1)(P<0.001)。多变量Logistic回归分析结果显示,GP73为显著肝脏炎症(P<0.001)及纤维化(P<0.05)的独立风险预测因素。结论 血清GP73与慢性乙肝患者肝脏炎症及纤维化程度均具有良好的相关性,可以作为预测肝脏炎症及纤维化的新型生物学标志物。

Objective To explore the correlation between serum Golgi protein 73(GP73)and both liver inflammation and fibrosis in patients with chronic hepatitis B(CHB).Methods Altogether 322 patients who underwent liver biopsy were enrolled in this retrospective study,and GP73,ALT,AST,LSM,FIB-4,APRI were analyzed.The relationship between serum GP73 and both liver inflammation and fibrosis was analyzed.Univariate and multivariate logistic regression analysis were used to evaluate the predictive value of GP73 for significant liver injury.Results 322 CHB patients ranged from 18 to 66 years old,including 231 males(71.7%)and 91 females(28.3%),and the median of GP73 was 65.6(35.8-129.6)ng/ml.The serum level of GP73 stepwise increased with increase of liver inflammation grade and liver fibrosis stage,and GP73 was significantly correlated with liver inflammation grade(ρ=0.536,P<0.001)and fibrosis stage(ρ=0.536,P<0.001).The degree of liver inflammation or fibrosis at the same stage was analyzed and the results indicated that the serum GP73 levels were significantly correlated with the severity of liver inflammation,while the association between serum GP73 and the stage of liver fibrosis was weaker.In term of the advanced liver inflammation or fibrosis stage,univariate and multivariate analysis revealed that GP73 was simultaneously determined as an independent risk factor for predicting liver inflammation(P<0.001)and fibrosis(P<0.05).Conclusion Serum GP73 is well correlated with liver inflammation and fibrosis in CHB patients,and it might be a new biomarker to predict liver inflammation and fibrosis.