超氧化物歧化酶在自身免疫性肝炎诊断及预后判断中的价值

Serum total superoxide dismutase level in patients with autoimmune hepatitis and its clinical significance

目的研究人血清中超氧化物歧化酶(superoxide dismutase,SOD)用于自身免疫性肝炎的诊断及预后判断的可行性,旨在为自身免疫性肝炎(autoimmune hepatitis,AIH)患者的临床诊疗提供参考。方法收集2016年8月1日-2019年8月1日在同济大学附属第十人民医院确诊的自身免疫性肝炎患者及健康体检者的血液标本,根据比色法检测患病组及健康对照组的血清总SOD水平,并收集两组的肝功能、血清免疫球蛋白G等相关临床数据。所有AIH患者入院后均参照治疗标准予以规范化治疗并对患者进行定期随访,参照标准评估预后情况。结果(1)血清总SOD在AIH组的表达低于健康对照组,AIH组与健康对照组比较差异有统计学意义(P<0.05)。(2)AIH患者血清总SOD与丙氨酸氨基转移酶、天冬氨酸氨基转移酶、总胆红素、碱性磷酸酶、γ-谷氨酰转肽酶、免疫球蛋白G呈负相关(P<0.01)。(3)血清总SOD检测对AIH的诊断有价值。灵敏度为78.85%,特异度为83.64%,Youden指数为0.625。(4)血清总SOD检测对AIH预后判断有意义。AIH患者中,疾病恶化风险因SOD降低这一暴露因素而增加。SOD水平高于115 U/mL的AIH患者预后良好,反之预后不良。结论血清总SOD可能对AIH的诊断有一定的参考价值,并有望成为AIH预后判断的途径之一。

Objective To investigate serum levels of total superoxide dismutase(SOD)in patients with autoimmune hepatitis(AIH)and its clinical significance.Methods Fifty-two patients with AIH diagnosed in Shanghai Tenth People's Hospital between August 2016 and August 2019 and 55 healthy subjects were enrolled in the study.Serum total SOD levels were detected by colorimetry,and clinical data and laboratory testing results in the two groups were collected.The values of serum total SOD levels in diagnosis and prognosis of AIH were analyzed.Results Serum total SOD level in the AIH group was lower than that in the healthy control group(P<0.05).Serum total SOD level in AIH patients was negatively correlated with ALT,AST,total bilirubin,alkaline phosphatase,γ-glutamyl transpeptidase,and IgG(P<0.01).The area under the ROC curve of serum total SOD in diagnosis of AIH was 0.89,and the sensitivity,specificity,and Youden index were 78.85%,83.64%,and 0.625 respectively.The prognosis of AIH patients with reduced SOD level(<115 U/ml)had poorer prognosis.Conclusion Serum total SOD levels in patients with AIH are lower than healthy subjects,which may be of certain reference value for the diagnosis of AIH and is expected to be one of the prognostic indicators for AIH.