果糖胺在不同肝脏疾病中的水平分析

Analysis of the level of fructosamine in liver diseases

目的探讨果糖胺在不同肝脏疾病中的水平。方法选择铜陵市立医院2016年10月至2017年10月住院的肝脏疾病患者153例作为研究组,其中慢性乙肝(CHB)患者58例为CHB组,肝硬化(LC)患者35例为LC组,原发性肝癌(HCC)患者60例为HCC组;同时选择健康体检者40例作为对照组。收集总蛋白(TP)、白蛋白(ALB)、胱抑素C(CysC)、唾液酸(SA)、空腹血糖(FBG)的数据进行统计分析。结果果糖胺在 HCC 组与 LC、CHB、对照组[(299. 1 ± 96. 9 )μmmol/L.( 259. 3 ± 41. 5)μmmol/L.( 248. 7 ±29.5)μmmol/L.(234.9 ±20. 2)μmmol/L]差异均有统计学意义(F = 11.321 <0. 05);FBG 在研究组与对照组之间差异无统计学意义(P>0.05)。相关性分析后,CHB组果糖胺与FBG有相关性(r = 0. 655,P <0. 05);LC组中果糖胺与TP.CysC、FBG均有相关性(r=0. 406、0. 418.0. 351,均P<0. 05);HCC组中果糖胺与TP、ALB、CysC、SA 均有相关性(r =-0. 513、- 0. 610、0. 637、0. 311,均 P< 0. 05),果糖胺与 FBG 无相关性(P >0.05)。HCC 组进行 logistic 逐步回归分析后,果糖胺(OR = 1. 029,95% CI: 1.007 1. 052)、CysC ( OR =5 454. 909,95%CI:78. 117 ~380 916.873)、SA(OR = 1.155,95% CI: 1.047 -1.275)是 HCC 的独立危险因子。结论CHB、LC患者果糖胺与FBG有相关性,HCC患者果糖胺可能与糖代谢无关,果糖胺反映HCC的肿瘤细胞的糖基化程度。

Objective To investigate the level of fructosamine in different liver diseases. Methods From October 2016 to October 2017, 153 patients with liver diseases hospitalized in Tongling Municipal Hospital were selected as study group,including 58 patients with chronic hepatitis B( CHB),35 patients with liver cirrhosis( LC), 60 patients with primary hepatocellular carcinoma ( HCC ). Meanwhile, 40 healthy subjects were selected as control group. The total protein(TP),albumin ( ALB),cystatin C( CysC),sialic acid( SA) and fasting blood glucose( FBG) were statistically analyzed. Results The difference of fructosamine between the HCC group and the LC group, the CHB group and the control group was statistically significant[(299. 1 ±96. 9)μmmol/L,(259. 3 ±41.5)μmmol/L,(248. 7 ±29. 5)μmmol/L,(234. 9 ±20.2)μmmol/L](F = 11.321 ,P<0.05). There was no statistically significant difference in FBG between the study group and the control group( P > 0. 05 ). Correlation analysis showed that there was a positive correlation between fructosamine and FBG in the CHB group(r = 0. 655 ,P < 0. 05 ). The fructosamine of LC group was positively correlated with TP, CysC and FBG ( r = 0. 406,0. 418,0. 351, all P < 0. 05 ). The fructosamine was correlated with TP, ALB,CysC and SA in HCC group(r =-0. 513,-0. 610,0. 637,r = 0. 311,all P <0. 05). There was no correlation between fructosamine and FBG in the HCC group (P >0. 05). Logistic stepwise regression analysis showed that in the HCC group,fructosamine( OR = 1.029,95% CI: 1.007 ~ 1.052),CysC ( OR = 5 454.909,95% CI:78.117 -380 916. 873) and SA(OR = 1. 155,95% CI: 1.047 ~ 1.275) were independent risk factors of HCC. Conclusion It has positive correlation between fructosamine and FBG in CHB and LC patients, fructosamine may not be related to glycometabolism in HCC patients, but the data of fructosamine reflect the degree of glycosylation of HCC tumor cells.