慢性HBV感染者血清IGF-1和IGFBP-3水平及其临床意义

Serum Levels of IGF-1 and IGFBP-3 in Patients with Chronic HBV Infection and Their Clinical Significances

目的通过检测慢性HBV感染者血清IGF-1和IGFBP-3水平,探讨其对于慢性HBV感染分期诊断的临床意义及应用价值。方法采用化学发光免疫分析法检测各组研究对象血清IGF-1和IGFBP-3水平。分析血清IGF-1和IGFBP-3水平在不同组别间的统计学差异及其与ALT等常用肝功能及肝损伤指标的相关性,并评价其在HBV感染相关炎症中的诊断效能。结果与健康对照组相比,慢性HBV感染患者的血清IGF-1和IGFBP-3水平低于健康对照组,差异有统计学意义(P均<0.05);运用ROC曲线对慢性HBV感染引起的肝脏炎症中ALT、IGF-1和IGFBP-3诊断效能进行计算、比较,结果显示3者的ROC曲线下面积(AUC)分别为0.933、0.611、0.743,其中ALT的灵敏度,特异性均高于IGF-1和IGFBP-3,但IGF-1和IGFBP-3均有预测价值(AUC>0.5),且3者联合检测时AUC可提高至0.946。结论IGF-1和IGFBP-3对于HBV感染引起的肝脏炎症有预测价值,虽然不能比ALT更好地反映HBV感染引起的肝脏炎症,但是ALT、IGF-1和IGFBP-3联合检测可提高诊断效能。

Objective To investigate the clinical significances and application values of serum IGF-1 and IGFBP-3 levels in patients with chronic HBV infection in the staging diagnosis of chronic HBV infection.Methods Chemiluminescence immunoassay was conducted to detect serum IGF-1 and IGFBP-3 levels in each group of subjects.We analyzed the statistical differences of serum IGF-1 and IGFBP-3 levels between different groups and their correlations with ALT and other common liver function and liver injury indicators,and then evaluated their diagnostic efficacy in HBV infection-related inflammation.Results Compared with the healthy control group,serum IGF-1 and IGFBP-3 levels of patients with chronic HBV infection were significantly lower than those of the healthy control group(P<0.05);ROC curve was used to analyze the liver caused by chronic HBV infection.The diagnostic efficacy of ALT,IGF-1 and IGFBP-3 in inflammation was calculated and compared.The results showed that the area under the ROC curve(AUC)of these three markers were 0.933,0.611,and 0.743,respectively.The sensitivity and specificity of ALT were higher than those of IGF-1 and IGFBP-3,but both IGF-1 and IGFBP-3 showed predictive values(AUC>0.5),and AUC could be increased to 0.946 when the three markers were combined.Conclusion IGF-1 and IGFBP-3 have predictive values for liver inflammation caused by HBV infection.Although they are not able to reflect liver inflammation caused by HBV infection better than ALT,the combined detection of ALT,IGF-1 and IGFBP-3 can improve the diagnostic efficiency.