外周血ALDH7A1 mRNA表达水平对乙肝后肝硬化患者Child分级和预后的评估价值

The value of peripheral blood ALDH7A1 mRNA in evaluation on Child grading and prognosis in HBV-related liver cirrhosis patients

目的研究外周血乙醛脱氢酶(ALDH7A1)mRNA表达水平对乙肝后肝硬化患者Child分级和预后的评估价值。方法收集健康志愿者(健康对照组)30例,乙肝后肝硬化患者90例(Child A、B、C级各30例)作为研究对象,检查临床生化指标,记录患者并发症发生情况,采用实时荧光定量反转录聚合酶链反应检测外周血ALDH7A1 mRNA表达水平。结果乙肝后肝硬化各Child分级组患者ALDH7A1 mRNA表达水平均较健康对照组明显下降,差异均有统计学意义(P<0.05);与Child A级组比较,Child B级组和Child C级组ALDH7A1 mRNA表达水平均明显下降,差异均有统计学意义(P<0.05)。ALDH7A1与丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、清蛋白、总胆红素、透明质酸、Child得分等多项指标有明显相关性(P<0.05)。ROC曲线分析显示,ALDH7A1 mRNA表达水平识别Child A级和B级的能力较强,ROC曲线下面积(AUC)为0.859,识别Child B级和C级的能力较弱,AUC为0.681。同时出现食管胃底静脉曲张、消化道出血、自发性腹膜炎、脾大等并发症的患者ALDH7A1 mRNA表达水平均明显低于无这些并发症的患者,差异均有统计学意义(P<0.05)。结论 ALDH7A1可能是乙肝后肝硬化疾病进展监控和预后判断的一项潜在生物标志物,对乙肝后肝硬化的早期Child分级诊断和预后指导具有重要参考价值。

Objective To explore the value of acetaldehyde dehydrogenase(ALDH7A1)mRNA on Child grading and prognosis in liver cirrhosis patients.Methods A total of 30 healthy controls(control group)and 90 liver cirrhosis patients were recruited.In patients,Child A,B and C had 30 patients respectively.Clinical parameters were collected,and complications were recorded.QRT-PCR was performed to detect the mRNA level of ALDH7A1.Results Compared with control group,ALDH7A1 mRNA were significantly lower in Child A,B and C groups(P<0.05).Compared with Child A group,ALDH7A1 mRNA of Child B and C groups were significantly lower(P<0.05).ALDH7A1 had correlation with alanine aminotransferase,aspartate aminotransferase,albumin,total bilirubin,hyaluronic acid and Child score(P<0.05).ROC analysis showed that ALDH7A1 had a higher AUC value(0.859)in differential diagnosis of Child A and Child B,and had a lower AUC value(0.681)in differential diagnosis of Child B and Child C.Furthermore,ALDH7A1 mRNA levels of patients with esophageal and gastric varice,gastrointestinal hemorrhage,spontaneous peritonitis and splenomegaly were significantly lower than those without complications(P<0.05).Conclusion ALDH7A1 may be a potential biomarker for Child grading and prognosis in liver cirrhosis patients which has important diagnostic value.