血清腺苷脱氨酶、补体C3、补体C4水平在诊断非酒精性脂肪性肝病患者肝纤维化中的临床意义

Clinical significance of serum levels of adenosine deaminase,complement C3 and complement C4 in the diagnosis of liver fibrosis in patients with nonalcoholic fatty liver disease

目的探讨血清腺苷脱氨酶(ADA)、补体C3、补体C4水平在诊断非酒精性脂肪性肝病(NAFLD)患者肝纤维化中的临床意义。方法选取该院2021年9月至2023年3月收治的83例NAFLD患者作为研究对象,根据入院时NAFLD肝纤维化评分(NAFLDFS)分为肝纤维化危险组(34例,NAFLDFS≥-1.455)和无肝纤维化组(49例,NAFLDFS<-1.455)。比较两组患者入院时血清ADA、补体C3、补体C4水平及肝纤维化指标,分析入院时血清ADA、补体C3、补体C4与肝纤维化指标及NAFLDFS评分的相关性,受试者工作特征曲线(ROC)分析入院时血清ADA、补体C3、补体C4水平联合检测对NAFLD患者肝纤维化的诊断价值。结果入院时肝纤维化危险组血清ADA水平高于无肝纤维化组,补体C3、补体C4水平低于无肝纤维化组(P<0.05);入院时肝纤维化危险组血清PCⅢ、CⅣ、LN、HA水平高于无肝纤维化组(P<0.05);相关性分析显示,入院时血清ADA水平与PCⅢ、CⅣ、LN、HA、NAFLDFS评分均呈正相关,补体C3、C4水平与PCⅢ、CⅣ、LN、HA、NAFLDFS评分均呈负相关(P<0.05);ROC曲线分析结果显示,入院时血清ADA、补体C3、补体C4水平联合诊断NAFLD患者肝纤维化的曲线下面积(AUC)为0.828,最佳诊断敏感度、特异度分别为94.12%、71.43%,高于单独指标诊断,具有较高诊断效能(P<0.05)。结论ADA、补体C3、补体C4参与NAFLD患者肝纤维化发生发展,且在诊断NAFLD患者肝纤维化方面具有较高效能。

Objective To investigate the clinical significance of serum adenosine deaminase(ADA),complement C3,and complement C4 levels in the diagnosis of liver fibrosis in patients with non-alcoholic fatty liver disease(NAFLD).Methods A total of 83 patients with NAFLD admitted to the hospital from September 2021 to March 2023 were selected as the study subjects.According to NAFLDFS score(NAFLDFS)at admission,they were divided into the liver fibrosis risk group(34 cases,NAFLDFS≥-1.455)and the non-fibrosis group(49 cases,NAFLDFS<-1.455).Serum ADA,complement C3,complement C4 levels and liver fibrosis indexes were compared between the two groups at admission,and the correlation between serum ADA,complement C3,and complement C4 at admission and liver fibrosis indexes and NAFLDFS score was analyzed.The receiver operating characteristic curve(ROC)was used to analyze the diagnostic value of serum ADA,complement C3,and complement C4 in the diagnosis of liver fibrosis in patients with NAFLD.Results The serum ADA level in the liver fibrosis risk group was higher than that in the non-fibrosis group,and the complement C3 and C4 levels were lower than those in the non-fibrosis group(P<0.05).The levels of serum PCⅢ,CⅣ,LN,and HA in the liver fibrosis risk group were higher than those in the non-fibrosis group(P<0.05).Correlation analysis showed that the serum ADA level was positively correlated with the scores of PCⅢ,CⅣ,LN,HA,and NAFLDFS at admission,while the complement C3 and C4 levels were negatively correlated with the scores of PCⅢ,CⅣ,LN,HA and NAFLDFS(P<0.05).The ROC curve analysis results showed that the area under the curve(AUC)of the combined diagnosis of serum ADA,complement C3 and complement C4 levels in NAFLD patients with liver fibrosis at admission was 0.828,and the best diagnostic sensitivity and specificity were 94.12%and 71.43%,respectively,which were higher than the diagnosis of single indicators and had high diagnostic efficacy(P<0.05).Conclusion ADA,complement C3,and complement C4 are involved in the occurrence and development of liver fibrosis in NAFLD patients and have high efficacy in the diagnosis of liver fibrosis in NAFLD patients.