血清半胱氨酸蛋白酶裂解细胞角蛋白18预测慢性乙型肝炎转归

The role of serum caspase-cleaved cytokeratin 18 in predicting the severity of chronic hepatitis B liver disease

目的探讨血清半胱氨酸蛋白酶裂解细胞角蛋白18(CK18)对慢性乙型肝炎肝病严重程度的预测价值。方法选取2017年3月至2018年3月府谷县人民医院收治的122例慢性乙型肝炎患者。按照METAVIR评分系统肝纤维化分期分为轻度肝纤维化组(n=69)、重度肝纤维化组(n=53);根据METAVIR评分系统肝脏炎症活动度分级分为轻度肝脏炎症组(n=76)、重度肝脏炎症组(n=46)。通过酶联免疫吸附试验测定血清CK18水平。结果轻度肝纤维化组血清CK18[167.86(89.54~274.65)U/L]水平显著低于重度肝纤维化组[231.98(132.09~564.38)U/L],差异有统计学意义(Z=12.765,P=0.002)。轻度肝脏炎症组血清CK18水平[138.23(165.34~677.46)U/L)]显著低于重度肝脏炎症组[337.43(82.87~234.15)U/L],差异有统计学意义(Z=15.917,P=0.001)。血清CK18预测慢性乙型肝炎患者严重肝脏炎症程度的预测效能更佳。结论血清CK18水平可用于预测慢性乙型肝炎重度肝脏组织炎症。

Objective To investigate the predictive level of serum caspase-cleaved cytokeratin 18(CK18)on the severity of chronic hepatitis B liver disease.Methods A total of 122 patients with chronic hepatitis B were collected from Mar.2017 to Mar.2018 in the People’s Hospital of Fugu County.According to the liver fibrosis stage of the METAVIR scoring system,the patients were divided into mild liver fibrosis group(n=69)and severe liver fibrosis group(n=53).Besides,according to the liver inflammation activity of METAVIR scoring system,the patients were divided into mild inflammation group(n=76)and severe inflammation group(n=46).Serum CK18 levels were determined by enzyme-linked immunosorbent assay.Results The level of serum CK18[167.86(89.54-274.65)U/L]in mild liver fibrosis group was significantly lower than that in severe liver fibrosis group[231.98(132.09-564.38)U/L,Z=12.765,P=0.002].The level of serum CK18 in mild inflammation group[138.23(165.34-677.46)U/L]was significantly lower than that in severe inflammation group[337.43(82.87-234.15)U/L,Z=15.917,P=0.001].The predictive role of serum CK18 on severe inflammation in patients with chronic hepatitis B was better than liver fibrosis.Conclusion Serum CK18 levels can be used to predict severe liver tissue inflammation in chronic hepatitis B.