血清IL-12、CDT、HGF和内毒素在不同阶段酒精性肝病中的诊断价值

Diagnostic Value of Serum IL-12,CDT,HGF and Endotoxin in Different Stages of Alcoholic Liver Disease

背景:酒精性肝病(ALD)的发病率逐年递增,但缺乏特异性诊断指标,探索ALD各阶段的分子标志物变化趋势对其诊断和治疗具有重要意义。目的:探讨血清白细胞介素(IL)-12、糖缺失性转铁蛋白(CDT)、肝细胞生长因子(HGF)和内毒素在不同阶段ALD中的水平及其诊断价值。方法:选取2017年7月—2018年1月包头医学院第二附属医院收治的19例酒精性肝硬化(AC)、14例酒精性肝炎(AH)、16例酒精性脂肪肝(AFL)、16例亚临床患者,以15名体检正常者作为健康对照。采用ELISA法检测血清IL-12、CDT、HGF水平,鲎试验检测内毒素水平。以ROC曲线分析IL-12、CDT诊断ALD的价值。结果:AC、AH患者血清IL-12、内毒素水平显著高于AFL、亚临床和健康对照组(P<0.05),AC、AH、AFL和亚临床组血清CDT水平均显著高于健康对照组(P<0.05),AC患者血清HGF水平显著高于AH、AFL、亚临床和健康对照组(P<0.05)。ALD患者血清IL-12、CDT、HGF与血清内毒素呈正相关(P<0.05)。截断值为55.06 pg/mL时,血清IL-12诊断ALD的敏感性和特异性分别为0.86和0.95;截断值为354.41 pg/mL时,血清CDT诊断ALD的敏感性和特异性分别为0.67和0.88。结论:血清IL-12、CDT、HGF和内毒素在ALD不同阶段存在趋势性变化,IL-12、CDT诊断ALD具有较高的敏感性和特异性,可作为ALD早期诊断的标志物。血清HGF和内毒素对评估ALD严重程度具有一定的价值。

Background:The incidence of alcoholic liver disease (ALD) is increasing year by year, and is lack of specific diagnostic indicators. Exploring the trend of molecular markers in different stages of ALD is of great significance for its diagnosis and treatment. Aims: To investigate the levels and diagnostic value of serum interleukin-12 (IL-12), carbohydrate-deficient transferrin (CDT), hepatocyte growth factor (HGF) and endotoxin in different stages of ALD. Methods: Nineteen patients with alcoholic cirrhosis (AC), 14 alcoholic hepatitis (AH), 16 alcoholic fatty liver (AFL), 16 subclinical patients from July 2017 to January 2018 at the Second Affiliated Hospital of Baotou Medical College were enrolled, and 15 healthy volunteers were served as healthy controls. Serum IL-12, CDT, HGF levels were detected by ELISA method, and serum endotoxin was detected by limulus test. Diagnostic value of IL-12, CDT for ALD was analyzed by ROC curve. Results: Serum IL-12, endotoxin were significantly increased in AC, AH groups than in AFL, subclinical patients, healthy controls (P<0.05);serum CDT level was significantly increased in AC, AH, AFL, subclinical patients than in healthy controls (P<0.05);serum HGF was significantly increased in AC patients than in AH, AFL, subclinical patients and healthy controls (P<0.05). Serum IL-12, CDT, HGF were positively correlated with serum endotoxin in ALD patients (P<0.05). When the cut-off value of serum IL-12, CDT were 55.06 pg/mL, 354.41 pg/mL, respectively, sensitivity for diagnosing ALD were 0.86, 0.67, respectively, specificity were 0.95, 0.88, respectively. Conclusions: Serum IL-12, CDT, HGF and endotoxin have a trend of change in different stages of ALD, and IL-12 and CDT have high sensitivity and specificity for diagnosing ALD, and can be used as markers for early diagnosis of ALD. Serum HGF and endotoxin are valuable for assessing the severity of ALD.