HBV感染不同状态者血清Tim-3的差异及与HBeAg和HBV DNA的关系

Differences of serum Tim-3 in patients with different hepatitis B virus infections and its relationship with HBeAg and HBV DNA

目的:探讨不同状态HBV感染者血清T细胞免疫球蛋白黏蛋白分子-3(Tim-3)差异,并分析其与HBeAg和HBV DNA的关系。方法:选取2017年6月至2019年6月于本院收治的50例HBV携带者(携带组)、60例慢性乙型肝炎患者(CHB组)、40例慢性乙型肝炎急性发作患者(急性发作组)和30例肝硬化患者(肝硬化组)作为研究对象,同期选取50例健康体检者作为对照组,同时检测各组对象ALT、HBeAg、HBV DNA、Tim-3水平,并做相关统计学分析。结果:携带组、CHB组、急性发作组、肝硬化组和对照组人员血清Tim-3水平分别为(13.79±3.52)、(15.04±4.38)、(21.32±5.44)、(1.11±5.83)和(10.57±2.45)pg/ml,5组比较差异有统计学意义(F=17.325,P=0.000);携带组、CHB组、急性发作组、肝硬化组患者和对照组人员血清ALT水平分别为(25.81±4.32)、(89.93±10.73)、(532.44±51.28)、(715.32±77.89)和(21.38±3.21)U/L,5组比较差异有统计学意义(F=45.271,P=0.000)。HBeAg阳性者和HBeAg阴性者血清Tim-3水平分别为(20.73±5.43)、(16.84±3.22)pg/ml,两者比较差异有统计学意义(t=5.297,P=0.000)。HBV DNA阳性者和HBV DNA阴性者血清Tim-3水平分别为(21.67±6.21)、(14.31±3.05)pg/ml,两者比较差异有统计学意义(t=10.356,P=0.000)。绘制ROC曲线发现,血清Tim-3在诊断HBV感染上具有一定价值(P<0.05),其曲线下面积为0.789,95%CI为0.711~0.842,截断值为16.45 pg/ml,敏感度为83.5%,特异度为80.1%。经Logistic回归分析发现,血清Tim-3是导致HBV进展的独立危险因素(P<0.05),OR值为1.83(95%CI:1.24~2.32)。结论:Tim-3在HBV感染不同状态者之间差异明显,且与HBeAg和HBV DNA状态相关,是导致HBV进展的独立危险因素。

Objective:To investigate the differences of serum T cell immunoglobulin mucin molecule-3(Tim-3)in patients with hepatitis B virus infection in different states,and to analyze its relationship with HBeAg and HBV DNA.Methods:From June 2017 to June 2019,50 patients with hepatitis B virus(carrying group),60 patients with chronic hepatitis B virus(CHB group),and 40 chronic hepatitis B writers(acute attack group)were selected.And 30 cases of chronic hepatitis B combined with liver cirrhosis group(cirrhosis group)as the research object,50 healthy subjects were selected as the control group at the same time;Tim-3,ALT,HBeAg and HBV DNA levels of each group were measured and collected for statistics Science analysis.Results:The serum Tim-3 levels in the carrier group,CHB group,acute attack group,cirrhosis group and control group were(13.79±3.52,15.04±4.38,21.32±5.44,17.11±5.83,and 10.57±2.45)pg/mL,five There were statistically significant differences between the two groups(F=17.325,P=0.000);the serum ALT levels in the carrier group,CHB group,acute attack group,cirrhosis group and control group were(25.81±4.32,89.93±10.73,532.44±51.28,715.32±77.89 and 21.38±3.21)U/L,the difference between the five groups was statistically significant(F=45.271,P=0.000).Serum Tim-3 levels in HBeAg-positive and HBeAg-negative patients were(20.73±5.43,16.84±3.22)pg/mL,respectively,and the difference was statistically significant(t=5.297,P=0.000).Serum Tim-3 levels were(21.67±6.21,14.31±3.05)pg/mL in HBV DNA positive and HBV DNA negative patients,respectively,and the difference was statistically significant(t=10.356,P=0.000).The ROC curve was drawn and found that serum Tim-3 has a certain value in the diagnosis of HBV infection(P<0.05).The area under the curve is 0.789,the 95%CI is 0.711~0.842,the cutoff value is 16.45 pg/mL,and the sensitivity is 83.5%,Specificity is 80.1%.Logistic regression analysis found that serum Tim-3 was an independent risk factor for HBV progression(P<0.05),and the OR value was 1.83(95%CI:1.24~2.32).Conclusion:Tim-3 has significant differences in different states of HBV infection,and is related to the status of HBeAg and HBV DNA,and is an independent risk factor for HBV progression.