高尔基体蛋白73对抗病毒治疗慢性乙型肝炎患者代偿期肝硬化的诊断价值

Diagnostic Value of Golgi Protein 73 in Compensatory Cirrhosis of Patients with Chronic Hepatitis B on Antiviral Therapy

目的探讨高尔基体蛋白73(gp73)和人尾肢同源蛋白2(pygo2)对抗病毒治疗慢性乙型肝炎(CHB)患者代偿期肝硬化的诊断价值。方法选取2019年1月—6月就诊的85例CHB患者为研究对象,根据诊断指标,同时结合临床表现及检查结果,将入选CHB患者分为肝炎组51例和代偿期肝硬化组34例。收集入组患者基本资料,计算天冬氨酸转氨酶和血小板比率指数(APRI)和基于4因子的纤维化指数(FIB-4),并测定gp73和pygo2蛋白浓度。建立几种常规无创诊断方式的受试者工作特征(ROC)曲线,并计算曲线下面积(AUC)。结果代偿期肝硬化组总胆红素、碱性磷酸酶、γ-谷氨酰转肽酶、APRI、FIB-4、肝硬度测定(LSM)值、gp73明显高于肝炎组,血小板计数明显低于肝炎组(P<0.05)。2组性别、年龄、丙氨酸转氨酶、天冬氨酸转氨酶和pygo2比较差异无统计学意义(P>0.05)。gp73的AUC=0.926、LSM值的AUC=0.757、FIB-4的AUC=0.742、APRI的AUC=0.713、pygo2的AUC=0.503,其中gp73最佳诊断点为2.7 ng/ml,敏感度91.2%,特异性86.3%;pygo2最佳诊断点为0.3 ng/ml,敏感度和特异性分别仅为50.0%和56.9%。结论gp73对抗病毒治疗CHB患者代偿期肝硬化的诊断价值优于pygo2。

Objective To investigate the diagnostic value of Golgi protein 73(gp73)and people end limb homologous protein 2(pygo2)in compensatory cirrhosis of chronic hepatitis B(CHB)patients on antiviral therapy.Methods A total of 85 CHB patients who were treated from January 2019 to June 2019 were selected as the research subjects.According to the diagnosis indexes,combined with the clinical manifestations and examination results,the CHB patients enrolled were divided into hepatitis group(n=51)and compensatory cirrhosis group(n=34).The basic data of the patients were collected,the aspartate aminotransferase-to-platelet ratio index(APRI)and the fibrosis index based on the 4 factors(FIB-4)were calculated,and the gp73 and pygo2 protein concentrations were determined.The receiver operating characteristic(ROC)curves of several conventional non-invasive diagnostic methods were established,and the area under the curve(AUC)was calculated.Results The total bilirubin,alkaline phosphatase,γ-glutamyl transpeptidase,APRI,FIB-4,liver stiffness measurement(LSM)value,gp73 in the compensatory cirrhosis group were significantly higher than those in the hepatitis group,while the platelet count was significantly lower than that in the hepatitis group(P<0.05).There were no statistically significant differences in gender,age,alanine aminotransferase,aspartate aminotransferase and pygo2 between the two groups(P>0.05).The AUC of gp73,LSM value,FIB-4,APRI and pygo2 was 0.926,0.757,0.742,0.713,and 0.503 respectively.The best diagnostic point for gp73 was 2.7 ng/ml,and the sensitivity and specificity were 91.2%and 86.3%respectively.The best diagnostic point for pygo2 was 0.3 ng/ml,and the sensitivity and specificity were merely 50.0%and 56.9%respectively.Conclusion gp73 is superior to pygo2 in the diagnosis of compensatory cirrhosis of patients with CHB on antiviral therapy.