血清APPL1、CTHRC1、胱抑素C水平联合检测诊断慢性HBV感染肝硬化患者Child-Pugh分级的价值

Value of combined detection of serum APPL1,CTHRC1 and cystatin C levels in diagnosis of Child-Pugh classification in patients with chronic HBV-liver cirrhosis infected

目的:观察血清磷酸酪氨酸衔接蛋白1(APPL1)、胶原三股螺旋重复蛋白1(CTHRC1)、胱抑素C水平联合检测诊断慢性乙型肝炎病毒(HBV)感染肝硬化患者Child-Pugh分级的价值。方法:选取2021年1月至2023年1月该院收治的136例慢性HBV感染肝硬化患者进行前瞻性研究,设为研究组。选取同期于该院体检的136名健康者为对照组。比较两组血清APPL1、CTHRC1、胱抑素C水平;比较不同Child-Pugh分级慢性HBV感染肝硬化患者入院时血清APPL1、CTHRC1、胱抑素C水平;采用Spearman相关性分析慢性HBV感染肝硬化患者入院时血清APPL1、CTHRC1、胱抑素C水平与Child-Pugh分级的相关性;采用受试者工作特征(ROC)曲线评估慢性HBV感染肝硬化患者入院时血清APPL1、CTHRC1、胱抑素C水平联合检测诊断Child-Pugh分级的价值。结果:入院时,研究组血清APPL1、CTHRC1、胱抑素C水平均高于对照组,差异有统计学意义(P<0.05);入院时,Child-Pugh分级为C级慢性HBV感染肝硬化患者血清APPL1、CTHRC1、胱抑素C水平均高于B级、A级者,且B级者高于A级者,差异均有统计学意义(P<0.05);Spearman相关性分析结果显示,慢性HBV感染肝硬化患者入院时血清APPL1、CTHRC1、胱抑素C水平与Child-Pugh分级均呈正相关(r>0,P<0.05);ROC曲线分析结果显示,慢性HBV感染肝硬化患者入院时血清APPL1、CTHRC1、胱抑素C水平联合检测诊断Child-Pugh分级为C级的AUC为0.931,具有较高诊断价值。结论:血清APPL1、CTHRC1、胱抑素C水平联合检测诊断慢性HBV感染肝硬化患者Child-Pugh分级的价值高于三者单项检测。

Objective:To observe value of combined detection of serum recombinant adaptor protein phosphotyrosine interaction PH domain and leucine zipper containing protein 1(APPL1),collagen triple helix repeat protein 1(CTHRC1)and cystatin C levels in diagnosis of Child-Pugh classification in patients with chronic hepatitis B virus(HBV)-infected liver cirrhosis.Methods:136 patients with chronic HBV-infected liver cirrhosis admitted to this hospital from January 2021 to January 2023 were selected for the prospective study and were set as the study group.136 healthy people who underwent physical examination in the hospital during the same period were selected as the control group.The serum levels of APPL1,CTHRC1 and cystatin C were compared between the two groups.The levels of serum APPL1,CTHRC1 and cystatin C in the patients with chronic HBV-infected cirrhosis with different Child-Pugh classifications were compared on admission.Spearman correlation analysis was used to analyze the correlations among the serum APPL1,CTHRC1,cystatin C levels and the Child-Pugh classifications in the patients with chronic HBVinfected cirrhosis on admission.The receiver operating characteristic(ROC)curve was used to evaluate the value of combined detection of serum APPL1,CTHRC1 and cystatin C levels in the diagnosis of the Child-Pugh classification in the patients with chronic HBV-infected cirrhosis on admission.Results:On admission,the levels of serum APPL1,CTHRC1 and cystatin C in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).On admission,the levels of serum APPL1,CTHRC1 and cystatin C in the patients with chronic HBV-infected cirrhosis with Child-Pugh grade C were higher than those in the patients with grade B and grade A,those in the patients with grade B were higher than those in the patients with grade A,and the differences were statistically significant(P<0.05).Spearman correlation analysis showed that serum APPL1,CTHRC1 and cystatin C levels on admission in the patients with chronic HBV-infected cirrhosis were positively correlated with the Child-Pugh classification(r>0,P<0.05).ROC curve results showed that the AUC of combined detection of serum APPL1,CTHRC1 and cystatin C levels on admission in the patients with chronic HBV-infected cirrhosis was 0.931 for the diagnosis of Child-Pugh grade C,which had high diagnostic value.Conclusions:The value of combined detection of serum APPL1,CTHRC1 and cystatin C levels in the diagnosis of Child-Pugh classification in the patients with chronic HBV-infected cirrhosis is higher than that of the single detection of the three.