慢性乙型肝炎病毒感染患者血清炎症因子水平与疾病进展研究

Serum inflammatory factor levels and disease progression in patients with chronic hepatitis B virus infection

目的探讨慢性乙型肝炎(乙肝)病毒感染患者血小板(PLT)、谷氨酰胺转移酶(GGT)、干扰素γ诱导蛋白-10(IP-10)水平与疾病进展相关性及防治意义。方法以2019年9月至2021年8月在商丘市某医院诊治慢性乙肝患者作为研究对象,根据疾病不同进展时期分别设置单纯性慢性乙肝(肝炎组)、慢性乙肝后肝硬化(肝硬化组)、慢性乙肝相关原发性肝癌(肝癌组),并设置健康体检人群作为对照组,对研究对象进行资料收集及体格检查,同时采集空腹静脉血用于白蛋白(ALB)、球蛋白(GLB)、谷草转氨酶(AST)、丙转转氨酶(ALT)、PLT、GGT、IP-10等指标检测,采用Pearson分析PLT、GGT、IP-10与肝功能指标相关性,采用受试者工作特征曲线(ROC)及ROC下面积(AUC)分析PLT、GGT、IP-10评估肝硬化、肝癌价值。结果共纳入524例不同疾病进展时期的慢性乙肝患者,肝炎组152例,肝硬化组141例,肝癌组131例,健康体检人群(对照组)140人,4组人群年龄、性别、饮酒史、吸烟史、既往疾病史比例差异均无统计学意义(均P>0.05),BMI分布差异有统计学意义(P<0.01)。4组人群的AST、ALT、GGT、IP-10、ALB、GLB、PLT检测结果及异常率差异均有统计学意义(均P<0.01)。PLT与AST、ALT呈负相关,与ALB、GLB呈正相关(P<0.01);GGT、IP-10与AST、ALT呈正相关,与ALB、GLB呈负相关(P<0.01)。绘制ROC曲线结果显示,PLT、GGT联合IP-10评估肝硬化的AUC为0.894,大于PLT(0.828)、GGT(0.798)、IP-10(0.717),PLT、GGT联合IP-10评估肝癌的AUC为0.945,大于PLT(0.854)、GGT(0.825)、IP-10(0.889)。结论PLT、GGT、IP-10在慢性乙肝、肝硬化、肝癌进程中呈动态变化,与慢性乙肝患者病情进展密切相关,可作为肝硬化、肝癌的预测标志物,为监测及防治慢性乙肝疾病进展工作提供参考。

Objective To investigate the correlation and prevention significance of platelet(PLT),glutaminyl‐transferase(GGT),and interferonγ-inducible protein-10(IP-10)levels with disease progression in patients with chron‐ic hepatitis B virus infection.Methods Patients with chronic hepatitis B diagnosed and treated in a hospital in Shangqiu City from September 2019 to August 2021 were selected as the research subjects.According to different stages of disease progression,set up a simple chronic hepatitis B group(hepatitis group),chronic hepatitis B post‐cirrhosis group(liver cir‐rhosis group),and chronic hepatitis B‐related primary liver cancer group(liver cancer group),and set up healthy people as the control group.Data collection and physical examination were performed on the research subjects.At the same time,fasting venous blood was collected for albumin(ALB),globulin(GLB),aspartate aminotransferase(AST),alanine ami‐notransferase(ALT),PLT,GGT,IP-10,and other indicators detection.Pearson analysis method was used to analyze the correlation between PLT,GGT,IP-10,and liver function indicators,and the receiver operating characteristic curve(ROC)and area under ROC(AUC)were used to analyze the value of PLT,GGT,and IP-10 evaluating the liver cirrhosis and liver cancer.Results A total of 524 chronic hepatitis B patients with different disease progression stages were includ‐ed,including 152 in the hepatitis group,141 in the liver cirrhosis group,131 in the liver cancer group,and 140 healthy people(control group).There was no significant difference in age,gender,drinking history,smoking history,and past disease history among the four groups(all P>0.05),but there was a significant difference in BMI distribution(P<0.01).The test results and abnormal rate of AST,ALT,GGT,IP-10,ALB,GLB,and PLT between the four groups were statisti‐cally significant(all P<0.01).PLT was negatively correlated with AST and ALT,and positively correlated with ALB and GLB(P<0.01);GGT and IP-10 were positively correlated with AST and ALT,and negatively correlated with ALB and GLB(P<0.01).The results of the ROC curve showed that the AUC of liver cirrhosis assessed by PLT and GGT combined with IP-10 was 0.894,which was more significant than PLT(0.828),GGT(0.798),and IP-10(0.717),and the AUC of liver cancer assessed by PLT and GGT combined with IP-10 was 0.945,which was more significant than PLT(0.854),GGT(0.825),and IP-10(0.889).Conclusion PLT,GGT,and IP-10 are dynamic changes in the process of chronic hepatitis B,liver cirrhosis,and liver cancer,which are closely related to the progress of chronic hepatitis B patients.They can be used as predictive markers of liver cirrhosis and liver cancer and provide a reference for monitoring and preventing chronic hepatitis B disease progression.