血清miR-455水平的变化对慢性乙型肝炎患者肝纤维化程度的诊断价值探究

Exploration on Diagnostic Value of Changes in Serum miR-455 Level on Degree of Hepatic Fibrosis in Patients with Chronic Hepatitis B

目的:探究血清miR-455水平的变化对慢性乙型肝炎(CHB)患者肝纤维化程度的诊断价值。方法:选取2015年1月-2018年12月间收治纳入的CHB患者50例资料,统计其常规血清学、病毒学检测结果和肝脏病理学评价结果,分析qPCR检测法检测的血清miR-455水平的变化,以及曲线下面积(AUC)的血清miR-455水平的变化对肝纤维化分级的诊断意义。结果:高病毒载量患者的血清miR-455水平高于低病毒载量患者(P<0.05);随着患者血清miR-455表达增加与肝纤维化程度具有相关性,依序为肝硬化(F4)、严重肝纤维化(F3)、显著肝纤维化(F2)、轻度肝纤维化(F1)和正常组织(F0)分别为(1.95±0.10)U/L(、1.72±0.18)U/L(、1.25±0.21)U/L(、0.93±0.22)U/L和(0.46±0.06)U/L(P值均<0.05),两者之间具有显著正相关(r=0.908,P<0.05);经ROC分析结果显示,当血清miR-455 Cut-off值(截断值)设置为≥1.035,≥1.583和≥1.806时,其诊断肝纤维化的AUC分别为F2(0.948),F3(0.965)和F4(0.982)。结论:血清miR-455水平的变化对提高肝纤维化的诊断具有较高的应用价值。

Objective: To explore the diagnostic value of changes in serum miR-455 level on the degree of hepatic fibrosis in patients with chronic hepatitis B(CHB). Methods: The data of 50 CHB patients admitted from January 2015 to December 2018 were selected, and the results of routine serological and virological tests and liver pathology evaluation were collected. The changes of serum miR-455 level detected by qPCR and the significance of serum miR-455 level changes in the area under the curve(AUC) for the diagnosis of hepatic fibrosis grading were analyzed. Results: The serum miR-455 level in patients with high viral load was higher than that in patients with low viral load(P<0.05). The increased expression of serum miR-455 in the patients was correlated with the degree of liver fibrosis, which was(1.95±0.10) U/L,(1.72±0.18) U/L,(1.25±0.21) U/L,(0.93±0.22) U/L and(0.46±0.06) U/L, respectively(P<0.05). There was a significant positive correlation between them(r=0.908, P<0.05). The results of ROC analysis showed that when the serum miR-455 cut-off value was greater than or equal to 1.035, 1.583 and 1.806, the AUC of diagnosis of liver fibrosis was F2(0.948), F3(0.965)and F4(0.982), respectively. Conclusions: The change of serum miR-455 level have a high application value in improving the diagnosis of liver fibrosis.