IL-33在诊断慢性乙型肝炎肝纤维化中的应用评价

Evaluation of IL-33 in the diagnosis of liver fibrosis in patients with chronic hepatitis B

目的:探讨慢性乙型肝炎(CHB)患者血清IL-33水平与肝纤维化的关系。方法:收集2017年1月至2019年6月于新乡医学院第一附属医院感染科住院的98例CHB患者和35例健康体检者作为研究对象,CHB患者均行B超检查和肝脏穿刺评估肝纤维化严重程度,肝脏生化及血常规指标均由我院检验科检测并计算FIB-4和S指数,血清IL-33水平采用ELISA试剂盒检测。分析IL-33与CHB患者肝纤维化严重程度的相关性及其诊断效能。结果:CHB患者血清IL-33水平同健康对照者相比显著升高(t=43.67,P<0.000),且随CHB患者肝纤维化程度的加重而升高(F=63.547,P<0.000);CHB患者血清中IL-33表达水平与PCⅢ(r=0.214,P=0.001)、Ⅳ-C(r=0.336,P=0.001)、HA(r=0.320,P=0.002)、LN(r=0.214,P=0.001)、B超评分(r=0.538,P<0.000)、FIB-4(r=0.614,P<0.000)和S指数(r=0.629,P<0.000)均呈显著正相关性。ROC结果显示,血清IL-33、FIB-4、S指数及B超评分诊断CHB患者发生肝纤维化的AUC分别为0.951(95%CI:0.905~0.996)、0.893(95%CI:0.830~0.955)、0.889(95%CI:0.826~0.951)和0.744(95%CI:0.641~0.847),与FIB-4、S指数和B超评分相比,血清IL-33诊断CHB患者发生肝纤维化的AUC较高,差异均有统计学意义(Z=24.03,Z=24.86,Z=40.21,P<0.05)。当IL-33截断值为563.52 pg/ml时,敏感度和特异度分别为92.14%和96.33%。结论:IL-33能准确评估CHB患者发生肝纤维化的程度,IL-33可成为诊断CHB患者发生肝纤维化的一项血清学标志物。

Objective:To investigate the serum IL-33 levels in patients with chronic hepatitis B(CHB)and its relationship with liver fibrosis.Methods:A total of 98 patients with CHB and 35 healthy peoples between January 2017 and June 2019 from the Department of Infectious Diseases,the First Affiliated Hospital of Xinxiang Medical University was collected.All patients with CHB were examined by B-ultrasound and liver puncture to evaluate the severity of liver fibrosis.The indexes of liver biochemistry and blood routine were detected by the Department of Laboratory of our hospital.The FIB-4 and S index were calculated.The serum IL-33 levels were detected by ELISA methods and to explore the correlation between serum IL-33 levels and the severity of liver fibrosis.The clinical value of IL-33 in the diagnosis of liver fibrosis in patients with CHB was also analyzed.Results:The serum IL-33 levels in patients with CHB was significantly higher than the healthy controls(t=43.67,P<0.000),and increased with the severity of liver fibrosis(F=63.547,P<0.000).There was a significant positive correlation between the serum IL-33 levels and PCⅢ(r=0.214,P=0.001),Ⅳ-C(r=0.336,P=0.001),HA(r=0.320,P=0.002),LN(r=0.214,P=0.001),B-ultrasonic scores(r=0.538,P<0.000),FIB-4(r=0.614,P<0.000)and S-index(r=0.629,P<0.000).The ROC results showed that the AUC of serum IL-33,FIB-4,S-index and B-ultrasonic scores in the diagnose of liver fibrosis in patients with CHB was 0.951(95%CI:0.905~0.996),0.893(95%CI:0.830~0.955),0.889(95%CI:0.826~0.951),and 0.744(95%CI:0.641~0.847),respectively.Compared with FIB-4,S-index and B-ultrasonic scores,serum IL-33 levels in the diagnose of liver fibrosis in patients with CHB were significantly higher(Z=24.03,Z=24.86,Z=40.21,P<0.05).When the cut-off value was 563.52 pg/ml,the sensitivity and specificity were 92.14%and 96.33%,respectively.Conclusion:IL-33 can accurately evaluate the severity of liver fibrosis in patients with CHB,and IL-33 may be as a serological marker of liver fibrosis.