miR-122及miR-155水平在乙型肝炎相关慢加急性肝衰竭患者中表达及临床价值

Clinical value of miR-122 and miR-155 levels in patients with hepatitis B-related cirrhosis

目的探讨miR-122、miR-155水平在乙型肝炎相关慢加急性肝衰竭患(HBV-associated Acute-on-chronic Liver Failure,HBV-ACLF)中的表达及临床价值。方法以我院收治的134例HBV-ACLF患者为HBV-ACLF组,同期选择134例慢性乙型肝炎(Chronic hepatitis B,CHB)患者为CHB组,选择134例体检健康者为对照组。比较三组miR-122、miR-155表达水平。HBV-ACLF组患者进一步根据ChildPugh分为A、B、C级亚组,比较亚组间miR-122、miR-155表达水平。分析HBV-ACLF组miR-122、miR-155表达水平与ChildPugh分级、ALT、AST、TBIL水平相关性。采用受试者工作特征(Receiver operating curve,ROC)曲线分析miR-122、miR-155对患者预后的临床价值。结果对照组、CHB组、HBV-ACLF组miR-122水平逐渐下降,而miR-155水平逐渐上升(P<0.05);ChildpughA、B、C级患者miR-122水平逐渐下降,而miR-155水平逐渐上升。相关性分析结果显示,ChildPugh分级、ALT、AST、TBIL水平与miR-122水平呈负相关,而与miR-155水平呈正相关(P<0.05)。当miR-122截断值为0.74时,评估患者预后的AUC为0.87;miR-155截断值为3.19时,评估患者预后的AUC为0.86。结论miR-122、miR-155水平与HBV-ACLF的发生发展密切相关,且上述指标检测在评估HBV-ACLF患者预后中具有一定临床价值。

Objective To investigate the expression and clinical value of miR-122 and miR-155 in patients with HBV associated acute liver failure(HBV ACLF).Methods 134 patients with HBV-ACLF in our hospital were selected as the HBV-ACLF group,134 patients with chronic hepatitis B(CHB)were selected as the CHB group at the same time,and 134 healthy persons were selected as the control group.The expression levels of miR-122 and miR-155 in the three groups were compared.Patients in HBV-ACLF group were further divided into A,B and C subgroups according to ChildPugh,and the expression levels of miR-122 and miR-155 were compared among subgroups.The correlation between the expression level of miR-122,miR-155 and ChildPugh grade,ALT,AST,TBIL in HBV-ACLF group was analyzed.The receiver operating curve(ROC)curve was used to analyze the clinical value of miR-122 and miR-155 in patients′prognosis.Results The level of miR-122 in control group,CHB group and HBV-ACLF group decreased gradually,while the level of miR-155 increased gradually(P<0.05);The level of miR-122 decreased gradually in children with grade A,B and C,while the level of miR-155 increased gradually.The results of correlation analysis showed that ChildPugh grade,ALT,AST,TBIL levels were negatively correlated with miR-122 levels,while positively correlated with miR-155 levels(P<0.05).When the cut-off value of miR-122 was 0.74,the AUC for evaluating the prognosis of patients was 0.87;When the cut-off value of miR-155 was 3.19,the AUC for evaluating the prognosis of patients was 0.86.Conclusion The levels of miR-122 and miR-155 are closely related to the occurrence and development of HBV ACLF,and the detection of these indicators has certain clinical value in evaluating the prognosis of patients with HBV ACLF.