血清TSP-2对非酒精性脂肪性肝病和肝纤维化诊断的价值

Clinical value of serum TSP-2 as a diagnostic indicator of non-alcoholic fatty liver disease and liver fibrosis

目的分析血清血小板反应蛋白2(TSP-2)与非酒精性脂肪性肝病(NAFLD)及肝纤维化程度的相关性。方法选取2018年3月至2021年4月于我院就诊NAFLD患者96例作为研究对象,以及100例健康志愿者作为对照组。采用酶联免疫吸附法分析血清TSP-2水平。应用瞬时弹性成像检查患者的肝纤维化程度。结果与对照组相比,NAFLD组患者血清TSP-2水平显著升高(P<0.001)。经受试者工作特征曲线(ROC)分析,血清TSP-2水平诊断NAFLD的曲线下面积(AUC)为0.784。经Spearman相关性和多元线性回归分析,NAFLD组患者血清TSP-2水平与FIB-4指数以及Fibroscan结果均呈正相关性(P<0.05),且血清TSP-2是影响NAFLD患者Fibroscan肝纤维化结果的独立因子(P=0.007)。F3~F4期患者的血清TSP-2水平显著高于F0~F2期患者(P<0.05)。经ROC曲线分析,血清TSP-2水平分别联合APRI及FIB-4诊断F3~F4期肝纤维化NAFLD患者的AUC分别为0.754、0.743,均优于它们单独预测(P<0.05)。结论NAFLD患者血清TSP-2水平普遍升高,且高血清TSP-2水平与肝纤维化进展有关,因此TSP-2可以潜在地作为NAFLD肝纤维化进展的候选标志物。

Objective To analyze the correlation between serum thrombospondin-2(TSP-2)and non-alcoholic fatty liver disease(NAFLD)and the degree of liver fibrosis.Methods A total of 96 patients with NAFLD and 100 healthy volunteers in our hospital from March 2018 to April 2021 were selected as the NAFLD group and control group.Serum TSP-2 levels were analyzed by enzyme-linked immunosorbent assay.Fibroscan was used to examine the degree of liver fibrosis.Results Compared with control group,serum TSP-2 level were significantly higher in NAFLD group(P<0.001).According to receiver operating characteristic curve(ROC)analysis,the area under curve(AUC)of serum TSP-2 level for the diagnosis of NAFLD was 0.784.Spearman correlation and multiple linear regression analysis showed that the serum TSP-2 level in NAFLD group was positively correlated with FIB-4 index and Fibroscan results(P<0.05).The serum TSP-2 level in F3~F4 patients was significantly higher than that in F0~F2 patients(P<0.05).According to ROC curve analysis,serum TSP-2 level combined with APRI and FIB-4 were 0.754 and 0.743 respectively in the diagnosis of NAFLD patients with liver fibrosis in F3~F4 stage,both of which were better than their prediction alone(P<0.05).Conclusion The serum TSP-2 level in patients with NAFLD is generally elevated,and the high serum TSP-2 level is associated with the progression of liver fibrosis.Therefore,TSP-2 may be a potential candidate marker for the progression of liver fibrosis in NAFLD.