原发性胆汁性胆管炎患者血清Cat S水平变化及诊断价值

The diagnostic value of serum Cat S level in patients with primary biliary cholangitis

目的探讨原发性胆汁性胆管炎(PBC)患者血清组织蛋白酶S(Cat S)水平变化及诊断价值。方法选取2017年6月至2020年10月焦作市人民医院收治的PBC患者75例和乙型肝炎患者60例。对比两组患者血清总Cat S、pro-Cat S及active-Cat S水平。采用Pearson分析PBC患者血清Cat S与碱性磷酸酶(ALP)、谷氨酰转肽酶(GGT)、免疫球蛋白G(IgG)及免疫球蛋白M(IgM)的相关性。绘制受试者工作特征曲线(ROC)以曲线下面积(AUC)评价血清Cat S对PBC的诊断价值。结果PBC组ALP、GGT、IgG及IgM水平分别为(258.76±82.56)U/L、(258.76±82.56)U/L、(258.76±82.56)g/L、(258.76±82.56)g/L,均高于HBV组的(187.52±64.38)、(215.33±76.21)、(8.32±2.45)、(2.53±1.05)(t=14.310、9.713、8.016,均P<0.05)。PBC组血清总Cat S、pro-Cat S及active-Cat S水平分别为(14.85±4.52)pg/L、(8.53±3.61)pg/L、(6.32±1.87)pg/L均高于HBV组的(5.26±2.85)pg/L、(3.82±1.15)pg/L、(1.44±0.75)pg/L,(t=5.481、8.078、10.098、6.668,均P<0.05)。PBC患者血清总Cat S与ALP、GGT、IgG及IgM均呈正相关(r=0.625、0.581、0.681、0.582,P<0.05);血清pro-Cat S与ALP、GGT、IgG及IgM均呈正相关(r=0.764、0.676、0.753、0.603,P<0.05)。ROC分析显示,血清总Cat S、pro-Cat S及active-Cat S诊断PBC的最佳截断点分别为8.79 pg/L、5.88 pg/L、3.16 pg/L,AUC分别为0.887、0.644、0.658。结论PBC患者血清Cat S水平异常偏高,对PBC诊断效能较高,可作为诊断PBC的重要参考指标。

Objective To investigate the changes and diagnostic value of serum cathepsin S(Cat S)level in patients with primary biliary cholangitis(PBC).Methods A total of 135 patients with PBC and hepatitis B(HBV)who were admitted from June 2017 to October 2020 were selected and denoted as PBC group(75 cases)and HBV group(60 cases),respectively.The serum levels of total Cat S,pro-Cat S and active-Cat S were compared between the two groups of patients.Pearson correlation analysis was used to explore the correlation between serum Cat S and alkaline phosphatase(ALP),glutamyl transpeptidase(GGT),immunoglobulin G(IgG)and immunoglobulin M(IgM)in PBC patients.Rreceiver operating characteristic curve(ROC)was drawn and the area under the curve(AUC)was used to evaluate the diagnostic value of serum Cat S for PBC.Results The levels of ALP,GGT,IgG and IgM in the PBC group were(258.76±82.56)U/L,(258.76±82.56)U/L,(258.76±82.56)g/L,and(258.76±82.56)g/L,respectively,which were all higher than those of[(187.52±64.38),(215.33±76.21),(8.32±2.45),(2.53±1.05)]in the HBV group(t=14.310,9.713,8.016;all P<0.05).Similarly,serum levels of total Cat S,pro-Cat S and active-Cat S in the PBC group were(14.85±4.52)pg/L,(8.53±3.61)pg/L,and(6.32±1.87)pg/L,respectively,which were higher than those of[(5.26±2.85)pg/L,(3.82±1.15)pg/L,(1.44±0.75)pg/L]in the HBV group(t=5.481,8.078,10.098,6.668;all P<0.05).Serum total Cat S level in PBC patients was positively correlated with ALP,GGT,IgG and IgM(r=0.625,0.581,0.681,0.582,P<0.05).Concordancely,serum pro-Cat S level was positively correlated with ALP,GGT,IgG and IgM(r=0.764,0.676,0.753,0.603,P<0.05).By ROC analysis it was shown that the best cut-off points for the diagnosis of PBC by serum total Cat S,pro-Cat S and active-Cat S were 8.79 pg/L,5.88 pg/L,3.16 pg/L,and the AUCs were 0.887,0.644,0.658,respectively.Conclusion The level of serum Cat S in patients with PBC is abnormally increased,and its diagnostic efficiency for PBC is high.Serum level of Cat S can be used as an important reference index for the diagnosis of PBC.