慢性乙型肝炎患者血清IP-10对肝损伤及纤维化辅助诊断价值

Primary Study on the Diagnostic Value of Serum IFN-gamma-inducible Protein 10 in Liver Injury and Fibrosis of Chronic Hepatitis B

目的探讨血清干扰素γ诱导蛋白10(IFN-gamma-inducible protein 10,IP-10)在慢性乙型肝炎(chronic hepatitis B,CHB)中的临床意义。方法共84例未经治疗的CHB患者和30例健康对照者被纳入研究。收集所有调查对象的年龄、性别、病史、血清HBV DNA水平、肝功能、肝脏硬度检测值(LSM)。通过ELISA方法检测血清IP-10水平,分析血清IP-10水平与其他指标的相关性;采用ROC曲线评价血清IP-10水平对CHB的诊断价值。结果CHB患者血清IP-10水平[(277.61±250.27)ng·mL-1]高于健康对照组[(29.94±16.90)ng·mL-1](t=8.996,P=0.0001)。CHB患者中血清IP-10水平在HBsAb和HBeAb阳性者高于阴性者,TBIL异常者高于正常者(P均<0.05);不同程度肝硬化和肝损伤CHB患者,血清中IP-10水平差异均有统计学意义(P均<0.01)。血清IP-10与LSM、AST、TBIL呈正相关,与HbeAb呈负相关(P均<0.01)。IP-10在本组数据中诊断AUC分别为:CHB发病0.938(0.896~0.981)(P=0.000),轻度肝损伤0.850(0.768~0.932)(P=0.000),中度肝损伤0.529(0.390~0.669)(P=0.738),重度肝损伤0.827(0.740~0.913)(P=0.000),轻度肝纤维化0.763(0.666~0.861)(P=0.001),中度肝纤维化0.533(0.415~0.651)(P=0.696),重度肝纤维化0.762(0.663~0.860)(P=0.003),肝硬化0.851(0.761~0.942)(P=0.000)。结论血清IP-10水平与慢性乙型肝炎所致的肝损伤及肝纤维化相关,具有潜在辅助诊断价值。

Objective To investigate the role of interferon gamma-inducible protein 10(IP-10)in liver injury and fibrosis caused by chronic hepatitis B(CHB).Methods A total of 84 patients with previously untreated chronic hepatitis B and 30 healthy controls were included in the study.ELISA was used to detect the serum IP-10 level.The physical condition of hepatic disease related detection of the subjects were examined and recorded.Correlation analysis was tested by spearman correlation coefficient.Receiver operating characteristic(ROC)curve analysis was performed to verify the clinical diagnostic value of IP-10.Results The serum IP-10 level was significantly higher in 84 CHB patients(277.61±250.27)(t=8.996,P=0.0001)compared with30 healthy controls(29.94±16.90).Positive HBs Ab,Positive HBe Ab and abnormal TBIL patients have higher IP-10 levels than negative HBs Ab,negative HBe Ab nad normal TBIL patients(P all<0.05).The serum levels of IP-10 in CHB patients with different degrees of cirrhosis and liver injury showed statistically significantdifferences(P all<0.01).The positive correlation between IP-10 and LSM,AST,TBIL were found in CHB specimens(P all<0.01)while the negative correlation was between IP-10 and Hbe Ab(P<0.01).IP-10 showed more effective diagnostic values in CHB diagnosis 0.938(0.896-0.981)(P=0.000),minimal liver injury 0.850(0.768-0.932)(P=0.000),medium grade liver injury 0.529(0.390-0.669)(P=0.738),severe liver injury 0.827(0.740-0.913)(P=0.000),minimal hepatic fibrosis 0.763(0.666-0.861)(P=0.001),medium grade hepatic fibrosis 0.533(0.415-0.651)(P=0.696),severe hepatic fibrosis 0.762(0.663-0.860)(P=0.003),liver cirrhosis 0.851(0.761-0.942)(P=0.000).Conclusion The serum level of IP-10 is closely related to the liver injury and liver fibrosis caused by chronic hepatitis B.IP-10 can be used as a specific serum marker for CHB diagnosis,early liver injury and liver fibrosis diagnosis and grading evaluation.